SSMJ February 2024


Address risk factors as part of clinical practice to prevent stroke

Part of this issue of the journal is dedicated to important aspects of prevention, diagnosis and management of stroke in low- and middle-income countries (LMICs).

News, Reports and Policy

Obituary: Dr Asia Dawud Kuek

Dr Asia Dawud Kuek Kuol Ajak died in Kampala Uganda on 17 January 2024 following a long battle with breast cancer.

Obituary: Dr Lou Joseph Bosco

Dr Lou Joseph Bosco died on 19 January, 2024 in Kampala, Uganda. Born on 5 July 1986, Dr Lou hailed from the Leri Pasobe Clan, Nyargang Boma of Kansuk Nyepo Payam in Kajokeji County.

Obituary: Gideon Wurube Kara

The medical fraternity in South Sudan has lost many of its own members in the last three months. SSMJ presents the obituaries of some of them.

Advertise in the South Sudan Medical Journal

Advertise in the South Sudan Medical Journal

Clinical Guidance

Hepatocellular carcinoma and aflatoxin in Sudan: The way forward

Hepatocellular carcinoma (HCC) is the sixth most common type of cancer and the third leading cause of death worldwide. It is especially prevalent in developing countries, with around 80% of cases occurring in Asia and Africa. Aflatoxin B1 is a well-documented risk factor for HCC, among other factors. In Sudan, there is limited reliable and comprehensive data on cancer epidemiology, including HCC. This paper focuses on the current status of HCC in Sudan, specifically in relation to aflatoxin. Additionally, recommendations are provided to enhance the control measures for HCC in the country.


Prevalence and perceptions of voluntary medical male circumcision among University of Juba students, South Sudan

Voluntary medical male circumcision (VMMC) is one of the key interventions against heterosexual spread of HIV. However, its prevalence in South Sudan is not clearly understood. This study aimed to assess the prevalence and perceptions of VMMC among University of Juba students.

Reference intervals for serum creatinine and urea in the adult western Sudanese population

Serum creatinine and urea levels are affected by numerous factors such as ethnicity, environment, age, sex, and anthropometric measurements. The Clinical and Laboratory Standards Institute (CLSI) recommends that each laboratory should establish its own reference intervals for biochemistry and haematology. There are no local reference intervals for serum creatinine and blood urea in Sudan; instead, intervals derived from worldwide research are used. The purpose of this study was to determine the blood urea and serum creatinine reference intervals for healthy adults in the Western Sudanese population.

Paranasal sinuses in patients with chronic rhinosinusitis,Tanzania

Chronic rhinosinusitis is inflammation of the nasal cavity and paranasal sinuses that lasts for at least twelve weeks. Paranasal sinus variations account for various pathologies, including chronic rhinosinusitis. This study assessed the anatomical variations of paranasal sinuses among patients with chronic rhinosinusitis attending otorhinolaryngology services in a tertiary hospital in Tanzania.

Stroke rehabilitation in low resource countries: time to provide an organised service

Stroke is one of the leading causes of death and disability in low- and middle-income countries (LMICs). The proven efficacy for rehabilitation interventions in improving stroke outcomes in LMICs supports the need to strengthen the rehabilitation workforce. Low-cost physical rehabilitation interventions requiring minimal resources, self-rehabilitation, tele-rehabilitation and involvement of family and other carers can be a solution and improve functional outcomes.

Case Reports

QUIZ: Unenhanced Brain Computerised Axial Tomographic (CAT) scan quiz

QUIZ: Unenhanced Brain Computerised Axial Tomographic (CAT) scan quiz

QUIZ Answers: Unenhanced Brain Computerised Axial Tomographic (CAT) scan quiz

QUIZ Answers: Unenhanced Brain Computerised Axial Tomographic (CAT) scan quiz


Risk factors for stroke in the African populace: need for action

The burden of stroke cannot be overemphasized especially in low and middle-income countries (LMICs). More than two-thirds of stroke deaths arise from these countries as well as nearly 90% of stroke-related morbidities. Unfortunately, it has been suggested that there might be up to a three-fold increase in stroke incidence and a higher prevalence in Africa in the year 2021.

Stroke units in low and middle income countries (LMICs) save lives: application of the western model of stroke care

Stroke is defined as a syndrome of rapidly developing clinical signs of focal or global disturbance of cerebral function with symptoms lasting 24 hours or longer or leading to death with no apparent cause other than of vascular origin. In the current management of stroke in developed countries, stroke units form a vital part of the care pathway.