Search

Objectives: This study aims to assess cancer patients' accessibility to healthcare services and perceived barriers during the COVID-19 pandemic in Khartoum state, aiming to explore the consequent impact on cancer patients. It also aims to determine the coping strategies used by patients to overcome these barriers. Study design: This is a retrospective analytical cross-sectional study. Methods: Data were collected from August 2020 to March 2021, with a sample size of 316 cancer patients. Systemic random sampling and SPSS version 25 were utilized for data collection and analysis. Results: The study found that 55.7 % of the surveyed cancer patients had experienced disruptions in accessing essential cancer healthcare services during the lockdown. The study identified the most common cancers as breast (19.7 %), gastrointestinal (19 %), and ovarian (11 %). Notable barriers included governmental travel restrictions (51.6 %), outpatient service closures (41.8 %), and high costs (27.8 %). Additionally, delayed treatment was directly associated with a 33.3 % fatality rate among the participants. Conclusions: This study highlights the considerable negative impact of the COVID-19 lockdown on cancer care in Sudan. Recommendations include a focus on telemedicine as an alternative form of patient consultation, the expansion of health insurance schemes to encompass cancer treatments, and strengthening healthcare infrastructure to facilitate cancer care during crises.

Purpose: Evaluate the utility of cardiac magnetic resonance imaging for noninvasive estimation of the key hemodynamic parameters that are measured by the right heart catheterization i.e. mean pulmonary artery pressure, pulmonary artery wedge pressure and pulmonary vascular resistance through cardiac magnetic resonance based numerical models. Materials and Methods: 29 pulmonary hypertension patients, fitting the inclusion criteria were randomly selected and included in the study. CMR Imaging and right-sided heart catheterization (RHC) were performed within 1 month. 3 Cardiac MRI based models in literature that showed high accuracy were tested. Two equations for mPAP calculation; mPAP= - 231.423 + loge inter-ventricular septal angle x 53.8 + log10 ventricular mass index (right ventricular mass/left ventricular mass) x 8.708 + diastolic pulmonary artery area x 0.009 and mPAP = -4.6 + (interventricular septal angle x 0.23) + (ventricular mass index x 16.3). One equation for PAWP; PAWP = 6.43 + LA volume index x 0.22. Results: The Pearson correlation test correlation between inva- sively quantified and CMR-estimated mPAP had good correlation with r = 0.594 and r = 0.599 (p < 0.001) for CMR based mPAP model 1 and 2, respectively. While, Altman and Bland test showed that The mean bias between the RHC-derived and CMR-estimated mPAP was 7.9 (agreement interval -24.8 to 40.6 mmHg) and mean bias -3 (agreement interval -34.8 to 28.2 mmHg) for CMR based mPAP model 1 and 2, respectively. There was no correlation between invasively quantified and CMR-estimated PAWP with (p = 0.092) for CMR based PAWP model. The mean bias between the RHC-derived and CMR-estimated PAWP was 2.4 (agreement interval -13.5 to 18.2 mmHg). The correlation between invasively calculated and CMR-estimated PVR had good correlation with r = 0.703 and r = 0.704 (p < 0.001) for CMR based PVR model 1 and 2, respectively. The mean bias between the RHC-derived and CMR-estimated mPAP was 0.6 (agreement interval -11.6 to 12.8 mmHg) and mean bias -1.3 (agreement interval -12.1 to 9.5 mmHg) for CMR based mPAP model 1 and 2, respectively. Conclusion: our results showed good correlations between CMR findings and RHC as regard mPAP and PVR. Thus Non-invasive estimation of mPAP, PAWP and PVR using CMR is feasible but needs further studies to improve accuracy. [ABSTRACT FROM AUTHOR]

Background: A central feature of most cases of bronchiectasis is airway inflammation. The elevated neutrophil count has been strongly correlated with impaired lung function, bronchiectasis severity, and disease duration. There is a failure of resolution of inflammation in bronchiectasis, leading to irreversible damage and dilatation of the bronchial airways with loss of mucociliary function. Lipoxins were the first agents to be identified as anti-inflammatory endogenous lipid mediators involved in the resolution of inflammation. Aim of the Work: This study aimed to measure Lipoxin A4 level in bronchoalveolar lavage (BAL) of children with Cystic Fibrosis bronchiectasis (CF) and Non-CF bronchiectasis as a prognostic marker for clinical and radiological severity in these children as regard Bronchiectasis severity score. Methods: A cross-sectional study was conducted at Children's Hospital, Ain Shams University from December 2020 to December 2021, on children following up at the Pediatric Pulmonology Clinic. The study included 15 patients with cystic fibrosis (CF) bronchiectasis, 15 patients with non-CF bronchiectasis, and 30 control cases, without breathing difficulty or signs of RDS. Human Lipoxin A4 was measured in BAL by ELISA. Results: There was a significant difference between patients and controls as regards Lipoxin A4 level (p = 0.002),being higher in control group, but no significant difference in its level between CF and non-CF bronchiectasischildren(p = 0.663). Conclusion: Severe bronchiectasis is associated with decreased airway Lipoxin A4 levels as lowest level of lipoxinA4 was found in severe cases by bronchiectasis severity score. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the leading cause of cancer related deaths worldwide. The combination of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) has a great impact on the diagnosis, staging, and hence on the treatment plan and follow up of lung cancer patients. Maximum standardized uptake value (SUVmax) is a semi-quantitative index which is easily performed and the most widely used quantitative parameter for the analysis of 18F-FDG PET images and for the estimation of metabolic activity. Objective: to investigate the role of PET/ CT to differentiate between adenocarcinomas (AC) and squamous cell carcinomas (SCC) as the most common lung cancer by comparing their FDG uptake measured in the form of SUVmax. Methods: A retrospective observational study, conducted at Ain Shams University Hospitals- Radiology Department patients diagnosed with non-small cell lung cancer (NSCLC) and histopathologically proved to be adenocarcinoma or squamous cell carcinoma. All were investigated using PET/CT scans in the period between June 2017 to September 2019. SUVmax of the lesion were measured and statistically analyzed compared with the histopathological type. Results: A total of 30 patients were evaluated with the age ranging from 31 to 81 years old, the mean was 56.9 years (SD611.53). Among them 25 patients (83.3%) were males and 5 patients (16.7%) were females. Out of the 30 NSCLC patients included in the study, 18 patients (60%) were histopathologically diagnosed as AC and 12 patients (40%) were histopathologically diagnosed as SCC. The mean SUVmax of the 30 NSCLC lesions was 15.0268.4 (range: 2-32.8).The mean SUVmax of AC lesions was 12.467.55 (range: 2-32.8), while the mean SUVmax of SCC lesions was 18.9568.3 (range: 3.7-30.77). The mean SUVmax of lesions in patients with SCC was significantly higher than that of patients with AC using Wilcoxon-Mann-Whitney test (P¼0.04). Conclusion: SCC of the lung has higher SUVmax than AC of the lung and it can be used to differentiate between them using PET/CT. [ABSTRACT FROM AUTHOR]

Terlipressin‐induced peripheral ischemia is a rare side effect of the drug, which should be timely identified and treated to prevent permanent necrosis. [ABSTRACT FROM AUTHOR]