Double teeth refer to two teeth that are totally or partially joined by dentin and maybe their pulps. These developmental anomalies may be the result of either gemination or fusion. This is a case of a 15-year-old Ind...Double teeth refer to two teeth that are totally or partially joined by dentin and maybe their pulps. These developmental anomalies may be the result of either gemination or fusion. This is a case of a 15-year-old Indo-Trinidadian male who presented with the fusion of a mandibular third molar with a distomolar as an incidental finding. The patient had his general dental care provided by a paediatric dentist and was referred to an oral and maxillofacial radiologist, orthodontist, and oral surgeon for consultation. A Cone-beam CT was taken to supplement the plain film periapical and orthopantomogram radiographs. It showed the three-dimensional orientation of the double molar and the extent of joining. This is the first case of fusion of a mandibular third molar to a distomolar being reported in the Caribbean.展开更多
Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric...Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric related conditions. Objectives: It aimed to determine rate, characters, morbidity and mortality of septic obstetric cases at Omdurman New Hospital. Methods: It was a descriptive, prospective, analytic, cross-sectional hospital based total coverage study;conducted at Omdurman New Hospital (ONH), Khartoum-Sudan. Results: Sever sepsis and septic shock rate 1.16 (13/1124 = 1.16%) of hospital pregnancy complication admission. Hyperthermia, Tachycardia and hypotension are the main presenting clinical findings and uterine infection is the main focus of sepsis. The mean average Intensive Care Unit (ICU) stay is 6.3-day. Organs dysfunctions are the main morbidity and mortality is reported in five cases. Conclusion: Sever sepsis and septic shock contributes in maternal morbidity and mortality. Safe obstetric care prevents maternal sepsis and improves the outcome. Management of sever sepsis and septic shock remains a challenge in obstetric medicine.展开更多
Objective To investigate the development of sexuality from early to late adolescence, and to compare girls and boys of different ages Methods A cross sectional survey in all schools was performed covering all pupils b...Objective To investigate the development of sexuality from early to late adolescence, and to compare girls and boys of different ages Methods A cross sectional survey in all schools was performed covering all pupils between 13 and 18 years of age that were in school when the survey was conducted. A validated instrument, Q90, created for use in teenagers was distributed in the class- rooms to 3 216 teenagers. Q90 covers 30 questions about body development and sexual behavior. Non-response was insignificant （n=19; 0.6%）. Results Pubertal development was considered “early” or “late” by about 50% of both boys and girls. Eighty percent of the 13 to 15 years old boys and girls had had a romance and 30% had experience of sexual cuddling （petting）, while significantly more girls than boys had sexual intercourse （18% vs 13%; odds ratio 1.5, 95% CI 1.1-1.9）. The difference between girls and boys remained in those being 16-18 years old, where 63% of the girls and 53% of the boys （odds ratio 1.5, 95% CIJ.2-1.9） admitted having intercourse. Mean age at first intercourse was 14.9 and 15 years, respectively. At 16-18 years of age, 23% of the sexually active girls, as compared with 25% of the boys estimated that they had had 6 or more sexual partners. About 30% of the adolescents, irrespective of age and gender, did not use contraceptives at their first and latest intercourse. Eight percent of the older girls had been pregnant, and they had an increased history of sexually transmitted infections, as compared with the boys （6.2% vs 2.7%, odds ratio 2.4, 95% CI 1.2-5.0）. Conclusion Exploring sexuality and experimentation is a normal behavior in adolescence. The results of this study, however, indicate that there are substantial groups of teenagers who practice sexual risk-taking. In addition to general sexual education, programs should also be directed to define sexual risks and its consequences.展开更多
Clinical, biochemical and molecular evidence for the sickle cell anemia （SCA） crisis in Nigerian patients arising from parvovirus b19 infection remains inadequate. This study determined the prevalence and correlates...Clinical, biochemical and molecular evidence for the sickle cell anemia （SCA） crisis in Nigerian patients arising from parvovirus b19 infection remains inadequate. This study determined the prevalence and correlates of antiparvovirus b19 antibodies in a population of SCA patients and non-SCA healthy controls in Lagos, Nigeria. In this prospective cross-sectional study, we enrolled 73 confirmed SCA patients from 5 district hospitals in Lagos and 81 sex and age-matched non-SCA healthy controls. Serum sample from each study participant was screened for anti-parvovirus b19 by ELISA and PCR techniques. Standard biomedical assays were also done. Anti-parvovirus b19 IgM and IgG antibodies were detected in 22 （14.3%） and 97 （62.9%） of the 154 sera screened, 13 （17.8%） and 45 （61.6%） in SCA patients; 9 （11.1%） and 52 （64.2%） in non-SCA controls. The overall seronegativity rate was 19.5%. Parvovirus B19 DNA was found in 2 （11.1%） of the 18 IgM seropositive SCA serum samples screened. On the whole, parvovirus b19 infection was more commonly asymptomatic in non-SCA controls but caused significant elevation in liver enzymes in infected SCA patients （P 〈 0.05）. The risk of acute parvovirus b19 infection increased 65 times during unsteady state among the SCA patients. Although no deaths of infected patients were recorded during the study, age below 12 years, hospitalization and overcrowded environment were risk factors for infection. We conclude that parvovirus b19 is common in SCA patients, incurring greater susceptibility to infections.展开更多
We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in g...We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in general anesthesia for retinopathy correction with subsequent difficult mechanical ventilation weaning. The benefit of spinal anesthesia in high-risk infant was described and the risks of spinal anesthesia in the presence of a ventricular shunt device-especially dural leakage and infections were briefly discussed.展开更多
Introduction: Caesarean section has avoidable morbidity which may lead to mortality especially in developing world. Caesarean section is a major operation which should be performed with maximum care and safety. Object...Introduction: Caesarean section has avoidable morbidity which may lead to mortality especially in developing world. Caesarean section is a major operation which should be performed with maximum care and safety. Objectives: This study aimed to find incidence, indications, procedures and maternal outcome of re-laparotomy after caesarean delivery. Methods: This was a descriptive cross sectional prospective total coverage hospital based study conducted at Omdurman Maternity Hospital from June 2014 to January 2015. Results: The incidence for re-laparotomy after Caesarean section is (0.66%) and the main indication for re-laparotomy is hemorrhagic events. Re-laparotomy outcome reported 22 cases (64.7%) alive and well and 6 cases (17.6%) alive with morbidity (renal failure and massive blood transfusion complications) and 6 cases (17.6%) of maternal mortality mainly due to sepsis. Conclusion: Re-laparotomy after Caesarean section is contributing to morbidity and maternal mortality. The majority of re-laparotomy was done after emergency Caesarean section. Lacks of skills, experience;safety measures of perfection and infection control are points to be concern.展开更多
Background: Trichomoniasis is a common Sexually Transmitted Disease (STD) and the most common curable one. Methodology: This was cross sectional, prospective, total coverage hospital based study. It aimed to determine...Background: Trichomoniasis is a common Sexually Transmitted Disease (STD) and the most common curable one. Methodology: This was cross sectional, prospective, total coverage hospital based study. It aimed to determine the incidence, risk factors of the Trichomoniasis among the laboring Sudanese women at Omdurman New Hospital Khartoum-Sudan, from September 2012 to April 2013. Data were obtained, entered and analyzed using soft word package program for social science (SPSS) version 17. Results: The prevalence of Trichomoniasis is 6.8%. It was found that the awareness about the infection is very low only 35%. Diabetes and history of sexual transmitted infections are the risks seen among the study cases. Preterm labor was seen significantly. Conclusion: Syndromic management of all women with abnormal vaginal discharge is important since it causes reproductive morbidity.展开更多
Introduction: Hyperemesis gravidarum (HG) is vomiting and/or nausea in pregnancy causes dehydration, electrolytes imbalance, weight loss and further serious organs dysfunction. Methods: This was a descriptive, prospec...Introduction: Hyperemesis gravidarum (HG) is vomiting and/or nausea in pregnancy causes dehydration, electrolytes imbalance, weight loss and further serious organs dysfunction. Methods: This was a descriptive, prospective, cross-sectional hospital based total coverage analytic study, which was conducted from November 2013 to May 2014 at Omdurman New Hospital (ONH) for Obstetrics & Gynecology, Khartoum-Sudan. Results: HG prevalence is 13% of complicated pregnancy of ONH admission. Acetonurea is reported in all cases with significant association between acetonurea and smoking (P value = 0.005). A significant association between Hemoglobulin level and the readmission the (P value = 0.01) was reported. One maternal death is reported from severe hypoglycemia and liver impairment. Conclusion: Hyperemesis gravidarum has serious maternal morbidity with social negative impacts and significant financial burden on the health services.展开更多
Aim: To describe Swedish children’ s growth (i.e. height, weight and body mass index) from birth to age 19 y. Methods: Every infant born on the 15th of any month in 1981 and living in Sweden as of 31 December 1989 wa...Aim: To describe Swedish children’ s growth (i.e. height, weight and body mass index) from birth to age 19 y. Methods: Every infant born on the 15th of any month in 1981 and living in Sweden as of 31 December 1989 was sampled. Longitudinal data were collected from childhood and school health records, and analysis by piecewise linear regression gave statistical descriptions of height, weight and body mass index for every age group. Results: The data include measurements of 3107 of 3158 sampled children; 1.6% of individuals are missing, so non- response bias is minimal. Thus, statistical descriptions and comparisons with similar data sets can be based on data with unusually high national representativeness. Selected subgroups (i.e. individuals born outside Sweden, suffering from chronic disease causing major growth impairment, or with birthweight < 2500 g) deviate in growth pattern, and exclusion of these subgroups increases means and decreases SD for height but only slightly influences summary statistics for weight and body mass index. Conclusion: This study represents, without selection bias, the current growth situation among children and adolescents in Sweden, enabling both epidemiological comparisons over time and comparisons with other national surveys.展开更多
Hyperinsulinism of infancy (HI) is a cause of persistent and recurrent hypoglycaemia in infancy and childhood, which if untreated can cause significant brain damage and mental retardation. The biochemical hallmark of ...Hyperinsulinism of infancy (HI) is a cause of persistent and recurrent hypoglycaemia in infancy and childhood, which if untreated can cause significant brain damage and mental retardation. The biochemical hallmark of hyperinsulinism is hypofattyacidaemic, hypoketotic hyperinsulinaemic hypoglycaemia. Diazoxide is the first line medical treatment for persistent HI. Diazoxide is an agonist of the pancreatic β-cell KATP channel and inhibits insulin secretion. Children who develop recurrent hypoglycaemia while on therapy with diazoxide are thought to be unresponsive to this medication or non compliant with medical therapy. We report a novel observation of “ketotic”hypoglycaemia in two children on diazoxide therapy for persistent HI. Detailed assessment of the intermediary metabolites and hormones at the time of the hypoglycaemia showed appropriate insulin suppression with appropriate increases in the serum levels of non-esterified fatty acids and ketone bodies as well as an intact counter-regulatory hormone response. The precise mechanism of the hypoglycaemia is unclear. Conclusion: These cases illustrate that recurrent hypoglycaemia while on diazoxide therapy may be due to other mechanisms and does not imply diazoxide unresponsiveness or non-compliance.展开更多
文摘Double teeth refer to two teeth that are totally or partially joined by dentin and maybe their pulps. These developmental anomalies may be the result of either gemination or fusion. This is a case of a 15-year-old Indo-Trinidadian male who presented with the fusion of a mandibular third molar with a distomolar as an incidental finding. The patient had his general dental care provided by a paediatric dentist and was referred to an oral and maxillofacial radiologist, orthodontist, and oral surgeon for consultation. A Cone-beam CT was taken to supplement the plain film periapical and orthopantomogram radiographs. It showed the three-dimensional orientation of the double molar and the extent of joining. This is the first case of fusion of a mandibular third molar to a distomolar being reported in the Caribbean.
文摘Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric related conditions. Objectives: It aimed to determine rate, characters, morbidity and mortality of septic obstetric cases at Omdurman New Hospital. Methods: It was a descriptive, prospective, analytic, cross-sectional hospital based total coverage study;conducted at Omdurman New Hospital (ONH), Khartoum-Sudan. Results: Sever sepsis and septic shock rate 1.16 (13/1124 = 1.16%) of hospital pregnancy complication admission. Hyperthermia, Tachycardia and hypotension are the main presenting clinical findings and uterine infection is the main focus of sepsis. The mean average Intensive Care Unit (ICU) stay is 6.3-day. Organs dysfunctions are the main morbidity and mortality is reported in five cases. Conclusion: Sever sepsis and septic shock contributes in maternal morbidity and mortality. Safe obstetric care prevents maternal sepsis and improves the outcome. Management of sever sepsis and septic shock remains a challenge in obstetric medicine.
文摘Objective To investigate the development of sexuality from early to late adolescence, and to compare girls and boys of different ages Methods A cross sectional survey in all schools was performed covering all pupils between 13 and 18 years of age that were in school when the survey was conducted. A validated instrument, Q90, created for use in teenagers was distributed in the class- rooms to 3 216 teenagers. Q90 covers 30 questions about body development and sexual behavior. Non-response was insignificant （n=19; 0.6%）. Results Pubertal development was considered “early” or “late” by about 50% of both boys and girls. Eighty percent of the 13 to 15 years old boys and girls had had a romance and 30% had experience of sexual cuddling （petting）, while significantly more girls than boys had sexual intercourse （18% vs 13%; odds ratio 1.5, 95% CI 1.1-1.9）. The difference between girls and boys remained in those being 16-18 years old, where 63% of the girls and 53% of the boys （odds ratio 1.5, 95% CIJ.2-1.9） admitted having intercourse. Mean age at first intercourse was 14.9 and 15 years, respectively. At 16-18 years of age, 23% of the sexually active girls, as compared with 25% of the boys estimated that they had had 6 or more sexual partners. About 30% of the adolescents, irrespective of age and gender, did not use contraceptives at their first and latest intercourse. Eight percent of the older girls had been pregnant, and they had an increased history of sexually transmitted infections, as compared with the boys （6.2% vs 2.7%, odds ratio 2.4, 95% CI 1.2-5.0）. Conclusion Exploring sexuality and experimentation is a normal behavior in adolescence. The results of this study, however, indicate that there are substantial groups of teenagers who practice sexual risk-taking. In addition to general sexual education, programs should also be directed to define sexual risks and its consequences.
文摘Clinical, biochemical and molecular evidence for the sickle cell anemia （SCA） crisis in Nigerian patients arising from parvovirus b19 infection remains inadequate. This study determined the prevalence and correlates of antiparvovirus b19 antibodies in a population of SCA patients and non-SCA healthy controls in Lagos, Nigeria. In this prospective cross-sectional study, we enrolled 73 confirmed SCA patients from 5 district hospitals in Lagos and 81 sex and age-matched non-SCA healthy controls. Serum sample from each study participant was screened for anti-parvovirus b19 by ELISA and PCR techniques. Standard biomedical assays were also done. Anti-parvovirus b19 IgM and IgG antibodies were detected in 22 （14.3%） and 97 （62.9%） of the 154 sera screened, 13 （17.8%） and 45 （61.6%） in SCA patients; 9 （11.1%） and 52 （64.2%） in non-SCA controls. The overall seronegativity rate was 19.5%. Parvovirus B19 DNA was found in 2 （11.1%） of the 18 IgM seropositive SCA serum samples screened. On the whole, parvovirus b19 infection was more commonly asymptomatic in non-SCA controls but caused significant elevation in liver enzymes in infected SCA patients （P 〈 0.05）. The risk of acute parvovirus b19 infection increased 65 times during unsteady state among the SCA patients. Although no deaths of infected patients were recorded during the study, age below 12 years, hospitalization and overcrowded environment were risk factors for infection. We conclude that parvovirus b19 is common in SCA patients, incurring greater susceptibility to infections.
文摘We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in general anesthesia for retinopathy correction with subsequent difficult mechanical ventilation weaning. The benefit of spinal anesthesia in high-risk infant was described and the risks of spinal anesthesia in the presence of a ventricular shunt device-especially dural leakage and infections were briefly discussed.
文摘Introduction: Caesarean section has avoidable morbidity which may lead to mortality especially in developing world. Caesarean section is a major operation which should be performed with maximum care and safety. Objectives: This study aimed to find incidence, indications, procedures and maternal outcome of re-laparotomy after caesarean delivery. Methods: This was a descriptive cross sectional prospective total coverage hospital based study conducted at Omdurman Maternity Hospital from June 2014 to January 2015. Results: The incidence for re-laparotomy after Caesarean section is (0.66%) and the main indication for re-laparotomy is hemorrhagic events. Re-laparotomy outcome reported 22 cases (64.7%) alive and well and 6 cases (17.6%) alive with morbidity (renal failure and massive blood transfusion complications) and 6 cases (17.6%) of maternal mortality mainly due to sepsis. Conclusion: Re-laparotomy after Caesarean section is contributing to morbidity and maternal mortality. The majority of re-laparotomy was done after emergency Caesarean section. Lacks of skills, experience;safety measures of perfection and infection control are points to be concern.
文摘Background: Trichomoniasis is a common Sexually Transmitted Disease (STD) and the most common curable one. Methodology: This was cross sectional, prospective, total coverage hospital based study. It aimed to determine the incidence, risk factors of the Trichomoniasis among the laboring Sudanese women at Omdurman New Hospital Khartoum-Sudan, from September 2012 to April 2013. Data were obtained, entered and analyzed using soft word package program for social science (SPSS) version 17. Results: The prevalence of Trichomoniasis is 6.8%. It was found that the awareness about the infection is very low only 35%. Diabetes and history of sexual transmitted infections are the risks seen among the study cases. Preterm labor was seen significantly. Conclusion: Syndromic management of all women with abnormal vaginal discharge is important since it causes reproductive morbidity.
文摘Introduction: Hyperemesis gravidarum (HG) is vomiting and/or nausea in pregnancy causes dehydration, electrolytes imbalance, weight loss and further serious organs dysfunction. Methods: This was a descriptive, prospective, cross-sectional hospital based total coverage analytic study, which was conducted from November 2013 to May 2014 at Omdurman New Hospital (ONH) for Obstetrics & Gynecology, Khartoum-Sudan. Results: HG prevalence is 13% of complicated pregnancy of ONH admission. Acetonurea is reported in all cases with significant association between acetonurea and smoking (P value = 0.005). A significant association between Hemoglobulin level and the readmission the (P value = 0.01) was reported. One maternal death is reported from severe hypoglycemia and liver impairment. Conclusion: Hyperemesis gravidarum has serious maternal morbidity with social negative impacts and significant financial burden on the health services.
文摘Aim: To describe Swedish children’ s growth (i.e. height, weight and body mass index) from birth to age 19 y. Methods: Every infant born on the 15th of any month in 1981 and living in Sweden as of 31 December 1989 was sampled. Longitudinal data were collected from childhood and school health records, and analysis by piecewise linear regression gave statistical descriptions of height, weight and body mass index for every age group. Results: The data include measurements of 3107 of 3158 sampled children; 1.6% of individuals are missing, so non- response bias is minimal. Thus, statistical descriptions and comparisons with similar data sets can be based on data with unusually high national representativeness. Selected subgroups (i.e. individuals born outside Sweden, suffering from chronic disease causing major growth impairment, or with birthweight < 2500 g) deviate in growth pattern, and exclusion of these subgroups increases means and decreases SD for height but only slightly influences summary statistics for weight and body mass index. Conclusion: This study represents, without selection bias, the current growth situation among children and adolescents in Sweden, enabling both epidemiological comparisons over time and comparisons with other national surveys.
文摘Hyperinsulinism of infancy (HI) is a cause of persistent and recurrent hypoglycaemia in infancy and childhood, which if untreated can cause significant brain damage and mental retardation. The biochemical hallmark of hyperinsulinism is hypofattyacidaemic, hypoketotic hyperinsulinaemic hypoglycaemia. Diazoxide is the first line medical treatment for persistent HI. Diazoxide is an agonist of the pancreatic β-cell KATP channel and inhibits insulin secretion. Children who develop recurrent hypoglycaemia while on therapy with diazoxide are thought to be unresponsive to this medication or non compliant with medical therapy. We report a novel observation of “ketotic”hypoglycaemia in two children on diazoxide therapy for persistent HI. Detailed assessment of the intermediary metabolites and hormones at the time of the hypoglycaemia showed appropriate insulin suppression with appropriate increases in the serum levels of non-esterified fatty acids and ketone bodies as well as an intact counter-regulatory hormone response. The precise mechanism of the hypoglycaemia is unclear. Conclusion: These cases illustrate that recurrent hypoglycaemia while on diazoxide therapy may be due to other mechanisms and does not imply diazoxide unresponsiveness or non-compliance.
