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A day with Mr. Hans Rosling a film by the swedish broadcasting service

Gharib Fawi Mohamed1, Taher Abd El-Raheem1, Nayel Abd El-Hamed Zaky2, Mohammed Abdal Abbas1, Islam Gad Elrap Ahmed1,

1Department of neuropsychiatry, Sohag University, Sohag, Egypt 2Department of internal medicine, Sohag University, Sohag, Egypt

Abstract
Background: peripheral Neuropathy (PN) is a well-known complication of chronic renal failure (CRF). The frequency of PN in patients with CRF has declined owing to improvement in the modalities and techniques of dialysis and uremic neuropathy can be considered as an indicator of inadequate treatment by dialysis Aim of the work: is to quantitively determine the electrophysiological changes in both peripheral and central nervous system in CRF and to determine the differences between CRF patients on dialysis and
those who don’t start dialysis yet regarding neuropathy and cognitive impairment.
Materials and Methodology: we studied two groups of patients from the dialysis unit in Sohag faculty medicine, in addition to a control group. Group I is patients with CRF, who recently diagnosed and where the decision of dialysis was taken (10 pts). Group II is on dialysis for more than one year (10 pts). All
patients were subjected to full clinical assessment relevant to the peripheral neuropathy, laboratory evaluation, abdominal ultrasonography, nerve conduction studies, electromyography, mini-mental state examination and P30
Result
Neuropathy is found in 75% of patients. NCS show that both motor and sensory fibers were affected and both axonal degeneration and demyelination were present. Neurophysiological abnormalities and cognitive impairment in group Ι were more than at group II
Conclusion
This study clearly demonstrated that neuropathy is very common in CRF patients and neurophysiological abnormalities in group Ι were more common than in group ΙΙ. This show the importance of hemodialysis in reduction of uremic neuropathy and its sensory symptoms

The road of our project starts in Perugia, the city Hospitals and Universities since the XIX century had been a crossroad of cultures, and the gateway to many medical disciplines. The larger area of Umbria somehow reflected this presence with a strong tradition in hosting foreign students. Starting from the local integration between residents and students a global mission may be seen in Medical initiatives here designed.
The word developing has been chosen as part of the title of our project. Although the term developing usually is criticized implying a contraposition between opposites (underdeveloped areas and developed world). It may also be criticized assuming a generic desire to ‘develop’ towards a traditional ‘Western’ model of economic development.

The use of the word developing next to medicine was intended to be broad and encompassing basic achievement of medical practice and education in both ‘worlds’ (the western and the emerging countries) integrated with the concept of international citizenry.

The debate between historical relativism and ethnocentrism (eurocentric perspective) provide frontiers where we can venture the great themes offered by the migration movements and emerging national health care systems.
The weapons that we are equipped with a deep faith in liberty, respect for the “other” cultures and the desire to offer a transparent and open discussion of the readers.

References

Antiseri D “Laicità le sue radici le sue ragioni” Rubbettino, Soveria Mannelli, 2010.

Corea F. Epidemiology and socioeconomic factors in Egypt. Neuroepidemiology. 2011;36(1):69. Epub 2011 Jan 19.

Modlin IM, Ahlman H. Oddi: the paradox of the man and the sphincter. Arch Surg. 1994 May;129(5):549-56.

Severi L. Sir Alexander Haddow and his beloved Perugia University Medical School (18. I. 1907 – 21. I. 1976). Lav Ist Anat Istol Patol Univ Studi Perugia. 1976;36(1):5-8.

A 50-year-old Nigerian man was admitted for generalized non febrile seizures. Two weeks before his GP prescribed antimalaric prophilaxis with clorochine for a planned trip in his home country. He suffered of a minor stroke 2 years before with no residual disability. He had also history of arterial hypertension treated with ace inhibitors and aspirin. At admission he was treated with lorazepam i.v. for a second generalized crisis at admission, and started carbamazepine 1000 per day. No other critical events were found during in hospital staying. A CT scan demonstrated the known subcortical right hemispheric hypodensity with no sulcal effacement or swelling features. Three months later carbamazepine was gradually intterrupted. After few months a new trip to Lagos was planned and chosen an antimalaric prophilaxis with Proguanil/Atovaquone (Malarone). The drug was well tolerated and no side effects were detected.

Take home message:
while choosing antimalaric prophilaxis a medical history of stroke and TIA may encourage the use of non epileptogenic drugs.

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