BackgroundIn this study, we share our experience of different operative techniques undertaken on 584 eumycetoma patients in the Gezira Mycetoma Center.MethodsThis is a retrospective, descriptive, hospital-based study, conducted to review the surgical treatment of eumycetoma patients. We included all patients diagnosed with eumycetoma who underwent a surgical operation in the center during January 2013–December 2016.ResultsA total number of 1654 patients were seen during the study period, and their records were revised, while 584 (35.3%) of them underwent an operation and included in the study. There was a male predominance 446 (76.4%). Surgical excision of mycetoma was the commonest operation performed among 513 (87.8%) patients in comparison with amputation 71 (12.2%). Below-knee amputation and toe amputation are the commonest types of amputation in 36 (6.1%) and 14 (2.3%) patients, respectively. Clinical features determining the type of operation performed included the size of the lesion, whether or not a bone was involved, and the feasibility of primary closure. A wide surgical excision (WSE) is performed mainly when the bone is not involved and when moderate or primary closure is possible or reconstruction is feasible. Amputations will typically follow identifying bone involvement, secondary infection, and an already disabled patient.ConclusionThe commonest procedure in our series was WSE and primary skin closure undertaken when the lesion was small (< 5 cm); there was no bone involvement, and the skin closure was achievable. Larger lesions (> 10 cm) without bone involvement were treated with excision and flap/graft. Bone involvement and large primary lesions were more likely to be managed by amputation. Recurrent and relapse of mycetoma were observed in patients with bone involvements or presented with recurrent mycetoma for the second time.
Background: Stigma is one of the major distresses that are experienced by people with mental illness. Stigmatisation results in a reduction in quality of life of those affected. Objective: The objective of this study was to assess the stigmatising attitudes of adolescents towards individuals with mental illness, their perception of community reaction and factors influencing it in Nigeria. Method:In school Adolescents (N = 402) participated in the research. They completed self-administered questionnaires regarding socio-demographic details and questions based on a vignette of a young person with a mental disorder using the Standardized Stigmatisation Questionnaire (SSQ1). The study was cross-sectional in nature and employed a multistage sampling technique. Result: The mean age was 14.44years (SD=1.84).There were 265 (65.9%) males and 137(34.1%) females. Approximately seventy percent of the adolescents would not be happy to sit next to a man with mental illness in a bus, 58.2% would not want him to teach their children, and an even higher percentage (72.9%) believe that most people in the community would do same. Seventy percent are aware that he did not develop his problems to avoid difficult situations of life and 78.2% also know that it's not a punishment for bad deeds. Independent predictors of stigma related attitude include age p<0.002, gender p<0.010 and community perception p<0.001. Conclusion: Stigmatisation of mental illness is highly prevalent among adolescents. Given that a significant percentage of the participants were well informed, formation of stigmatising attitude towards mental illness might be deeper than lack of knowledge. There may be a need to work on societal structure despite traditional education interventions and also encourage their contact with mentally ill persons.
Background: Teaching emergencies has the ability to provide medical students with animportant knowledge and skills. In this study, we assessed the perception of
Background: Squamous cell carcinoma (SCC) which originated in the urothelium of the urological system is not uncommon; however, it is rare in the renal pelvis. Additionally, it is hard to be diagnosed without high clinical suspicion.Case summary: A-66-years old female presented with left loin pain for 6 years, hematuria, and fever for months. Examination revealed no abnormality apart from pallor and bimanually palpable left kidney. Her investigations showed normal renal function and anemia, Computer Topography for Kidney, Ureter, and Bladder (CT-KUB) revealed a large left renal pelvic stone with a hugely enlarged kidney with suspicion of xanthogranulomatous pyelonephritis (XGPN), with almost absent function of the left kidney in DTPA. She underwent Left trans-peritoneal radical nephrectomy. Post-operative histopathology result was moderately differentiated squamous cell carcinoma (T3, N0, M0). To our knowledge this was the first reported case in our hospital, we think that the treatment was fair putting in mind the poor prognosis of the condition and the difficulty in diagnosis.Conclusion: This case demonstrates renal pelvis SCC presented with radiological features suggestive of xanthogranulomatous pyelonephritis.
Background: Prostate cancer (PCa) is considered one of the major health threats facing males in Sudan. Prostate-specific antigen (PSA) test is the most important laboratory test used in the diagnosis of prostate cancer, the main disadvantage of PSA is its limited specificity, which triggered a lot of interest in development, more research on other markers such as serum human kallikrein-2 (KLK-2) and free prostate specific antigen (fPSA). Objectives: To evaluate the validity of serum kallikrein-2 (KLK-2) and free prostate specific antigen (fPSA) in the early detection of prostate cancer among Sudanese patients. Method: In this study seventy men were considered as a case subject, who were diagnosed as cancer prostate at Gezira Hospital for Renal Disease and Surgery (GHRDS), Sudan during the period February 2018 to July 2019. Randomly selected sixty patients of BPH patients and forty-five apparently healthy men as control subject. KLK-2, fPSA and PSA estimations were performed from serum samples using the principle of Enzyme Linked Immunosorbent Assay (ELISA). Results: The results revealed a highly significant difference between the serum levels individual biomarkers (KLK-2, fPSA, PSA) and multiple biomarkers (fPSA/PSA, KLK-2/fPSA, KLK-2/PSA) for patients with prostate cancer when compared with the control groups. Furthermore, the fPSA/PSA ratio was lower in the patients with prostate cancer (P value = 0.00) than in the control group, the fPSA/PSA ratio showed that best accuracy to differentiate prostate cancer from control group, fPSA cut-off value was How to cite this paper: Yousif, O.K.
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