Background: Tuberculosis (TB) is one of the major health challenges in many developing countries and in Sudan in particular. The aim of this study was to screen pediatric patients suspected with lymph Node (LN) TB for the presence of tuberculosis. Methodology: This study investigated retrospectively 42 LN biopsies taken from pediatric patients for evidences indicating the presence of Mycobacterium Tuberculosis (MT). Hematoxylin and Eosin (HE), Zielnelson (ZN), Immunohistochemistry (IHC) and Polymerase Chain Reaction (PCR) techniques were used for diagnosis. Results: For HE giant cell granuloma and caseation were evidenced in 33/42(78.6%), since epitheloid granuloma was evidenced in 9/42(21.4%). Positive ZN, IHC and PCR were indicated in 1/42(2.4%), 33/42 (78.6%) and 33/42(78.6%), respectively. Conclusion: pediatric TB is still prevalent in some parts of Sudan. More effective health strategies are urgently needed in Sudan, particularly in eastern Sudan to control the disease.
Background: The growth of antibiotic-resistant bacteria has been accelerated in recent decades as a result of antibiotic abuse and misuse. The goal of the current study was to evaluate the misuse of pediatric antibiotics in Northern Saudi Arabia concerning upper respiratory tract infections (URTI) and diarrhea. Methodology: Between May and August 2022, 400 residents of Hail, Northern Saudi Arabia, participated in this community-based descriptive survey. Independent of their age, social position, educational attainment, or monthly income, the participants were picked at random. Results: Approximately 56.7% of fathers and 63% of mothers had engaged in antibiotic abuse. Most frequently, age between 35 and 45 years was implicated in antibiotic overuse 41.6%, followed by age between 25 and 35 years 36%. University graduates made up the majority of antibiotic misusers 63.7%, whereas those with secondary and primary educations made up 28.7% and 7.6%, respectively. Conclusion: In Northern Saudi Arabia, overuse of antibiotics is common, particularly among fathers' parents. Community-based educational initiatives on antibiotic abuse are necessary for addition to wristband laws to minimize antibiotic overuse in Northern Saudi Arabia.
Background: The incidence of esophageal cancer continues to rise in Sudan. High risk Human papilloma virus (HR-HPV) has been postulated to play a major etiological role in the development of esophageal carcinoma. The aim of the present study was to identify HR-HPV 16 & 18 among Sudanese patients with esophageal cancer.
Introduction: Hyponatremia and/or hypoglycorrhachia are commonly encountered biochemical derangements during the acute stage of childhood tuberculous meningitis (TBM). Few studies have explored the correlation between these derangements and the staging of TBM disease (severity), or explored their role as biomarkers for vascular ischemic events, hydrocephalus, or seizures.Methods: We aimed to identify the prevalence and the correlation between serum hyponatremia (mild, moderate and severe) and/or hypoglycorrhachia in relation to clinical TBM features such as stage of disease, seizures and stroke in children diagnosed with definite and probable TBM, between 1985 and 2015, at Tygerberg Hospital, Cape town, South Africa.Results: The prevalence of hyponatremia was 344 out of 481 (71.5%) patients; 169 (49.1%) had mild hyponatremia, 146 (42.4%) moderate hyponatremia and 29 (8.4%) severe hyponatremia. Children with severe hyponatremia had higher frequency of stroke [odds ratio (OR) 4.36, 95% confidence interval (CI) 1.24–15.35; p = 0.01], brainstem dysfunction (OR 7.37, 95% CI 2.92–18.61; p < 0.01), cranial nerve palsies (OR 2.48, 95% CI 1.04–5.91; p = 0.04) and non-communicating hydrocephalus (OR 2.66, 95% CI 1.09–6.44; p = 0.03). Children with moderate hyponatremia and mild hyponatremia compared to those without hyponatremia similarly were more likely to exhibit signs of brainstem dysfunction (OR 1.91, 95% CI 1.11–3.28; p = 0.02) and hydrocephalus (OR 3.18, 95% CI 1.25–8.09; p = 0.01), respectively. On multivariable analysis only brainstem dysfunction was significantly associated with severe hyponatremia [adjusted odds ratio (aOR) 4.46, 95% CI 1.62–12.30; p < 0.01]. Children with hypoglycorrhachia compared to normoglycorrhachia were more likely to have had longer symptom duration prior to admission (OR 1.87, 95% CI 1.09–3.20; p = 0.02), non-communicating hydrocephalus (OR 1.64, 95% CI 0.99–2.71; p = 0.05), higher cerebrospinal white cell counts (OR 3.00, 95% CI 1.47–6.12; p < 0.01) and higher CSF protein concentrations (OR 2.51, 95% CI 1.49–4.20; p < 0.01). On multivariable analysis raised CSF protein concentration >1 g/L was significantly associated with hypoglycorrhachia (aOR 2.52, 95% CI 1.44–4.40; p < 0.01). Death rates did not differ by sodium level category or presence of hypoglycorrachia, however an increasing trend of children that had demised was noted the more severe the sodium category.Conclusion: Hyponatremia and/or hypoglycorrhachia occur in more than two-thirds of children with TBM. Severe TBM disease complications such as brainstem dysfunction was associated with moderate hyponatremia, while severe hyponatremia was associated with brainstem dysfunction, stroke, cranial nerve palsies and non-communicating hydrocephalus. Cerebrospinal fluid (CSF) glucose depletion correlated with non-communicating hydrocephalus and increased CSF inflammation.
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