Department of Surgery

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    Anxiety and Depression among a Sample of Disfigured Orofacial Cancer Patients at Khartoum Teaching Dental Hospital
    (university of khartoum, ) Al Bdour, Zakaria Mahfouz ; Elneel Ahmed Mohamed
    Background: Patients treated for orofacial cancer have rarely been investigated for psychological morbidity. To address this problem, this study was conducted to estimate the relative prevalence of anxiety and depression in a sample of disfigured Sudanese patients with orofacial cancer. The main objectives of this study is to find the prevalence of anxiety and depression among facially disfigured patients and to study some of their common predictors namely the age, gender and the education level, and to analyze their relationship. Methods: Descriptive Cross sectional hospital-based study. Psychometric data were collected from a series of 51 disfigured orofacial cancer patients by questionnaires at Khartoum Teaching Dental Hospital over five months period from Nov.2016-March2017. The Hospital Anxiety and Depression Scale were used. Data that collected from the patients included the name, age, gender, and the patient’s educational level. Results: 41.2% of patients exhibited symptoms of psychiatric disturbance; 21.6% were anxious, and 19.6% were depressed. Anxiety was reported in 9.7% of males and in 40% of females. Depression was reported in 6.5% of males and in 40% of females. Anxiety and depression where seen most among young patients of age group 18-29 years (28.6%). Among all patients who are anxious the illiterate category scored the highest level with 45.5% while among the depressed ones the category of elementary education scored the highest level with 50%. Conclusion: The finding of this study showed that anxiety and depression are common among Sudanese patients with facial disfigurement. Women who are disfigured by orofacial cancer are at greater risk for psychosocial dysfunction, therefore screening for anxiety and depression should be a part of routine clinical evaluation for all patients particularly the females who should receive a greater attention in terms of evaluation and treatment.
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    Clinical Aspects of Hydronephrosis in Sudanese Patients
    (University of Khartoum, ) Nasr, Abdelrahman Hassan ; - ; surgery
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    The Effect of Relaxation Technique Combined with Cognitive Behavioural Therapy on Spiritual Well Being among Females Following Kidney Transplantation in Khartoum State 2015
    (University of Khartoum, ) Nour, Safa Mohammed Mohammed ; Mohamed Toum Musa MD ; Surgery
    Background: Spiritual well-being is one of the fundamental concepts in chronic diseases which create meaning and purpose in life and is an important approach in promoting general health and quality of life. The objective of this study was to assess the effect of relaxation technique compound with cognitive behavioural therapy (CBT) on spiritual well-being among females who had kidney transplantation. Patients and methods: This was an interventional study conducted at Sudanese Kidney Transplant Association Hospital, during (October 2014 – October 2015).Twenty one married women with renal transplantation were included. Spirituality was assessed by functional assessment of chronic illness therapy- spirituality version 12 (FACIT-sp 12) which composed of physical, social, emotional and functional well-being. The score of well-being ranged from 56-100 concerning the all components of (FACIT-sp 12). Married women were selected because there was a question about sexual life. Results: The age of the study population was 18 to 65 years. The effect of the interventional program on the physical well-being showed that p values were found to be in the pretest-posttest (p= 0.01),in posttest-follow-up (p= 0.00) and pretest follow-up (p= 0.00) . However, the effect of the interventional program on social well-being showed p values in the pretest-postest (P= 1.00),in posttest-follow-up (P= 0.10) and pretest-follow-up (P= 0.10) . Moreover, the effect of the interventional program on emotional well-being revealed significance of (p value=0.05) in the pretest-posttest versus posttest-follow-up in which (p value =0.03),and pretest-follow-up (p value= 0.24). On the other hand, the effect of interventional program on functional well-being showed significant improvement (p value =0.04) of pretest-posttest, (p value = 0.00) in posttest-follow-up and even more in pretest-follow up (p value= 0.00). Conclusion: The relaxation technique compound with cognitive behavioral therapy had positive effect on spiritual well-being among females with kidney transplantation. There was statistically significant relation between spirituality and age but, there was insignificant relation between spirituality, income, and level of education.
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    Surgery Breast Cancer Females University of Khartoum
    (University of Khartoum, 2004) Abu Bakr Hassan Widatalla Omer ; Ahmed Hassan Fahal ; Surgery
    Breast cancer is the commonest malignancy in females worldwide and Sudan is not an exception. It was noticed that breast cancer in Sudanese women occurs in younger age group and it is usually associated with aggressive behaviour; and the outcome of treatment is usually poor. These features differ from that observed in western communities and the explanation for this is so far unclear. This study was set out to determine the clinicopathological prognostic factors of breast cancer among Sudanese females, trying to explain its aggressive behaviour. This is a prospective study including 89 patients with breast cancer. The cases were recruited from the breast clinic, Soba University Hospital, Khartoum, Sudan. Patients with metastatic disease, patients with locally advanced disease who underwent toilet mastectomy, those who received neoadjuvant chemotherapy, and patients with recurrent breast cancer were excluded from the study. The study proved that patients at a young age group are more affected, with the mean age of 45.9 years. The menopausal status of the patients was not proved to be significantly associated with aggressive biological behaviour of the tumour. Most of patients presented with large tumour sizes (mean 5.9 cm); and the larger tumour sizes were significantly associated with positive axillary lymph nodes. Most of patients (65%) had positive axillary lymph nodes. The tumours showed high incidence of lymphatics and blood vessels invasion, reported in 63% and 34% respectively; and both are significantly associated with high metastatic potentials to the axillary lymph nodes. Using the Scraff-Bloom-Richardson Classification 65.2% of the patients had poorly differentiated adenocarcinomas. The higher tumour grades were significantly associated with axillary lymph node metastasis, and bigger tumour sizes due to the high doubling time. Most of the breast carcinomas in this study are of the invasive dutal carcinoma not otherwise specified (89%). Of the non-invasive type, ductal carcinoma in situ (DCIS) is the commonest. According to the American Joint Committee on Cancer (AJCC) tumour staging most of patients (56.7%) had stage III. Patients with tumour skin involvement and large tumour size at presentation are more likely to have positive surgical resection margins. 57.3% of patients had a poor Nottingham Prognostic Index (NPI). None of the patients had and excellent NPI. Patients with tumour necrosis and fibrotic foci showed higher frequency of lymph node metastasis. Concomitant fibrocystic disease of the breast with tumour cells was detected in 12.5% of our patients.