Acute renal failure and infectious mononucleosis

Renal failure is a rare complication of infectious mononucleosis, and is usually due to acute interstitial nephritis. Outcome has been variable with spontaneous recovery, death, and chronic renal failure being described. Only two patients have been reported as requiring dialysis. In some cases the aetiology of the interstitial nephritis has been open to doubt and may have been drug-induced. The case of a patient with acute renal failure associated with infectious mononucleosis and in whom interstitial nephritis appears to have been totally related to the underlying disease is described. There was an excellent response to treatment with high doses of methyl prednisolone given intravenously.     

Gastrointestinal bleeding in patients with acute spinal injuries

Twenty out of 365 patients (5.5 per cent) with acute spinal cord injuries referred to a spinal ward over a $\text{9}\text{1}\text{2}$-year period bled from the gastrointestinal tract.A cause of the haemorrhage was found in 15 patients. Six patients were endoscoped. Most patients had gastroduodenal ulceration but we could not be certain whether this was due to stress or peptic ulceration. We did not confirm that cervical cord lesions were associated with a higher incidence of gastrointestinal bleeding.The 4 patients who died probably represent an ‘inevitable’ mortality in severely ill patients.The role of endoscopy is outlined, the pathogenesis of gastrointestinal ulceration discussed and future management of these patients is suggested.     

Ethnicity and diabetes complications in Sudanese population: The need for further genetic population testing

BackgroundThe aim of the present study was to assess whether there is an association between ethnicity and the high prevalence of diabetes complications in Sudan.MethodsThis was cross-sectional hospital-based study with 316 individuals with diabetes conducted in Khartoum state, Sudan. A questionnaire was used to collect demographic information. In addition to measurements of blood pressure, lipid profile and HbA1c, weight and height measurement were also performed for calculation of body mass index.ResultsThe study included individuals recruited from 62 tribes across Sudan. The effect of ethnicity on diabetic septic foot (DSF) was not statistically significant across different tribes (X-squared = 2.6098, df = 4, p-value = 0.6251). The effect of ethnicity on Albuminuria was also not statistically significant across different tribes recruited for this study (X-squared = 4.3787, df = 4, p-value = 0.3572). The Northern group carried a significantly higher unadjusted risk for development of retinopathy (OR = 1.8471, p-value = 0.04603). The Southern group was significantly different from the others regarding the effect of ethnicity on neuropathy, compared to the ‘West' group (OR = 0.1905, p-value = 0.0345). The unadjusted effect for the Southern group was also significant (OR = 0.2933, p-value = 0.0320).ConclusionThere was no role of ethnicity in term of DSF and albuminuria complications. However, retinopathy likely to be seen in tribes originally from north of Sudan, while neuropathy is more likely to be found in tribes originally from the south of Sudan. Further focus genetic population testing is needed.     

Traumatic posterior dislocation of hip joint with a fracture of the head and neck of the femur on the same side: a case report

This case has been presented because of its unusual nature. It was primarily a dislocation injury of the hip joint, complicated by an associated fracture of the femoral head and neck. A possible explanation for this combination of injuries is presented.