Shadad M. Mahmoud

University of Khartoum

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

Mohamed E. Ahmed

Mayo Clinic

AbuBakr H. Widatalla

Sudan Childhood Diabetes Association

Abdelsamie Abdalla Mohamed

University of Khartoum

Seif ElDin I. Mahadi

University of Khartoum

Eltaib Saad

Saint Francis Hospital

Han-Tsung Liao

Chang Gung Memorial Hospital

Mohamed A. Shawer

Sudan Childhood Diabetes Association

Seifeldin Ibrahim Mahadi

University of Khartoum

Kamal Eldein Hamed Mohamed

University of Khartoum

Elbadwai Hassan-Mohamed HabibAlla

Cooperative Institutions

University of Khartoum

Sudan Childhood Diabetes Association

Ain Shams University

Chang Gung Memorial Hospital

Chang Gung University

Linkou Chang Gung Memorial Hospital

Memorial Hospital of South Bend

Taoyuan Chang Gung Memorial Hospital

Mayo Clinic

King Saud bin Abdulaziz University for Health Sciences

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Surgical Management of Breast Cancer among Sudanese Patients = الإدارة الجراحية للسرطان الثدي بين المرضى السودانيين

Sudan Medical Journal (2014)

Wafa N. E. Elhadi Shadad M. Mahmoud Mohamed E. Ahmed

10.12816/0015570

Cite

Citations (2)

Tobacco and alcohol use as risk factors for major lower extremity amputation in diabetics

Deleted Journal (2012)

Elsadig S Adam Shadad M. Mahmoud Mohamed E. Ahmed

Objectives: This study was designed to asses the prevalence and characteristics of smoking and alcohol drinking among diabetics and non diabetics in Sudan, in addition to evaluation of the relation between these factors and major lower extremity amputation (LEA) in diabetics and the role of smoking cessation on the risk of major LEA. Methods: This is a case control study which included 65 male diabetics who had major LEA as cases, 110 diabetics and 110 non diabetics as control groups. A major LEA was defined as any Below Knee Amputation (BKA) or proximal. Results: There was a strongly significant association between smoking >10 cig/d and amputation compared with those who smoked 20 pack-years versus < 20 pack-years and never smokers. 66.7% of the amputees were heavy alcohol drinkers (200g/week) versus 55.8% of the diabetic controls, O.R 1.59, 95% CI 0.49-5.24, (P=0.55). Conclusion: Cigarette smoking is associated, in a dose response manner, with the rate of amputation. Alcohol drinking did not show a statistically significant relation to amputation in diabetics. *Corresponding author: Department of Surgery, Faculty of Medicine, University of Khartoum. E mail: rasheid@usa.net

Source

Cite

Citations (1)

Patterns of finger sepsis and predictors of its outcome in patients with diabetic septic hand

International Journal of Diabetes in Developing Countries (2017)

Mugahid A. Salih Shadad M. Mahmoud Mohamed E. Ahmed

Gangrene

Etiology

10.1007/s13410-017-0589-7

Cite

Citations (2)

Clinical Research on Foot & Ankle

Waiel Faisal Abdel Wahab Seif ElDin Ida Arinah Mahadi Shadad M. Mahmoud

Background: The isolation of Pseudomonas organism in diabetic foot infection (DFI), is notorious of being multidrug resistant. The objective of this study is to report on the incidence, antibiotic sensitivity, treatment and outcome of pseudomonas infection. Patients and methods: This is a prospective observational analytic hospital based study in which all diabetic patients with Pseudomonas aeruginosa infected wounds seen in JADC during 18 months period were included. Results: Pseudomonas was grown in 302 out of 3620 cultures (8.3%) of whom 70 cultures were true pathogenic (1.9%). 41.4% of patients infected with pseudomonas were clinically septic when first seen in the clinic of whom 92.9% were febrile at presentation and 67.1% had chills. Ceftriaxone and ciprofloxacin were the most commonly used antibiotics. Amikacin was the most sensitive antibiotics in 77.1%. All patients took antibiotics >21 days after the isolation of pseudomonas to complete the eradication in combination of daily sharp excision of all coloured infected tissues. Forty six patients (66%) needed amputation, 30 had minor toes (43%) and 16 had transtibial amputation, (23%). Conclusion: Diabetic foot infected with pseudomonas carries a higher risk for toe or lower limb amputation. For complete medical eradication of P. aeruginosa; antibiotics should be used for at least 21 days combined with daily sharp excision of infected discoloured tissues.

Amikacin

Pseudomonas infection

Source

Cite

Citations (3)

The Response, Operability, and Type of Surgery Following Neoadjuvant Chemotherapy in Sudanese Patients with Locally Advanced Breast Cancer

Sudan Journal of Medical Sciences (2018)

Abdelsamie Abdalla Mohamed Kamal Eldein Hamed Mohamed Eltaib Saad Shadad M. Mahmoud

Neoadjuvant Therapy

Complete response

10.18502/sjms.v13i3.2961

Cite

Citations (3)

Gynecomastia in adult Sudanese patients

Deleted Journal (2016)

Abdalsemie Abdalla Mohamed Haitham Omer Ahmed Shadad M. Mahmoud

Objectives: To assess the magnitude of gynaecomastia and to investigate its presentations and the underlying causes in adult Sudanese patients who presented to Soba University hospital and Khartoum Teaching hospital during the period between April 2005 and August 2013 Patients and methods: This is a retro-prospective analytical hospital based study of all patients presenting with gynaecomastia during the period between April 2005 and August 2013. Data from notes including presentation, examination, investigations and management was collected, and analysed. Results: One hundred forty one adult patients with a mean age of 30 years were included in this study. The underlying causes of gynaecomastia in this study were hypogonadism in 14.6%, medications in 14.6%, chronic liver disease in 4.9% and testicular tumours in 2.4%. The commonest medications related to gynaecomastia were Cimetidine and Spirinolactone. Idiopathic gynaecomastia was diagnosed in 53.7% and it is strongly related to obesity, as more than 53.7% of patients were having a body mass index (BMI) above 25. Surgery and liposuction were performed in 70.7% of cases and the rest of patients were either treated medically or reassured. Conclusion: Careful history taking, physical examination and subsequent selective investigations are important in dealing with patients presenting with gynaecomastia. Causes are usually benign and surgery is indicated in 70% of patients including excision and liposuction.

Gynecomastia

Liposuction

Presentation (obstetrics)

Source

Cite

Citations (1)

The Response, Operability, and Type of Surgery Following Neoadjuvant Chemotherapy in Sudanese Patients with Locally Advanced Breast Cancer

Sudan Journal of Medical Sciences (2018)

Abdelsamie Abdalla Mohamed Kamal Eldein Hamed Mohamed Eltaib Saad Shadad M. Mahmoud

Background: Neoadjuvant chemotherapy (NACT) treatment has become the standard treatment for locally advanced breast cancer (LABC) in many centers worldwide.Objectives: This study evaluates the short-term response of patients with LABC to NACT and its impact on operability and the type of surgery.Patients and Methods: This is a descriptive analytical hospital-based study including 147 patients with LABC who were presented to Plastic and Reconstructive Surgery Unit at Soba University hospital (SUH), between January 2012 and December 2014, and were treated with NACT. Clinical and pathological responses to neoadjuvant chemotherapy were evaluated according to Union for International Cancer Control criteria, operability, and the type of surgery performed was also recorded.Results: All patients were females, the mean age was 43 ± 7 years, of them 53.7% were pre-menopausal, 51% presented with a breast lump, 19.7% with nipple discharge, and 19% with skin changes and ulceration. The mean initial tumor size was 7 cm ± SD. Following NACT, complete clinical response was reported in 30 patients (20.4%), partial clinical response in 92(62.6%), stable clinical response in 20 (13.6%), and five (3.4%) had progressive clinical response. Initial smaller tumors (size < 5 cm) showed a better clinical response to NACT as 76.7% of complete clinical response was achieved. Pathological complete response was achieved in 25(17%) patients, pathological partial response in 102(74.1%), and pathological stable disease in 13(8.8%). Following NACT, breast conserving surgery was performed in 78(53.1%) patients, Modified Radical Mastectomy in 64(43.5%), 25 of them had Latissimus Dorsi, and five patients were not offered surgery as they developed progressive disease during the study period.Conclusion: Following NACT, it was possible to perform surgery in more than 96% of patients with LABC.Keywords: locally advanced breast cancer, neoadjuvant chemotherapy treatment, clinical response, pathological complete response, operability

Complete response

Reconstructive Surgery

Neoadjuvant Therapy

10.4314/sjms.v13i3

Cite

Citations (0)

Extended leg infection of diabetic foot ulcers: risk factors and outcome

Journal of Wound Care (2011)

K.M. Adam Shadad M. Mahmoud Seif I. Mahadi AbuBakr H. Widatalla Mohamed A. Shawer

To identify the risk factors for extension of infection to the leg in diabetic foot ulcers (DFU) and to evaluate its role as a prognostic measure regarding limb salvage and healing time.This retrospective case-control study took place in Jabir Abu Eliz Diabetic (JADC) during 2006-2008. Forty-eight patients diagnosed with a diabetic foot ulcer (DFU) with the infection extending to the leg (case group) were compared with an equal number of patients with a DFU without extension (control group). Risk factors for extension were identified by univariate analysis and both groups were compared with regard to limb salvage and healing time.Previous history of toe amputation was more frequent in the case group (p=0.004). The case group patients were significantly more likely to present with fever (p=0.01), pallor (p=0.02), confusion (p=0.04), and necrosis (p=0.004). Ulcers located in the heel were more frequent in the case group when compared with controls (p=0.0001) while more toes ulcers were found in the control group (p=0.001). A significant number of patients in the case group had an ulcer of more than 5cm diameter compared with those in the control group (p=0.001). The total number of patients presented with severe disease (Wagner grade 3-5) was significantly more in the case group compared with controls (p=0.004). Patients with severe infection (grade 4) were more in the case group compared with the controls (p=0.04). There were no significant differences between the two groups with regard to major and minor amputation rate. The case group had a longer duration of healing when compared with the controls. Seventy-five per cent of the controls healed by 6 months (n=31) compared with 22% in the case group (n=8 ; p=0.001).Toe amputation, wound located in the heel, wound size more than 5cm and advanced Wagner grade (3-5) and severe sepsis, grade 4, may be considered as risk factors for extension of infection to the leg in DFU. However, this extension did not carry a poor prognostic value to the final outcome if adequate therapeutic measures were followed.

Diabetic foot ulcer

Pallor

Univariate analysis

10.12968/jowc.2011.20.9.440

Cite

Citations (19)

Aesthetic and Functional Outcome of Zygomatic Fractures Fixation Comparison With Resorbable Versus Titanium Plates

Annals of Plastic Surgery (2015)

Shadad M. Mahmoud Han-Tsung Liao Chien-Tzung Chen

The study compares resorbable versus titanium fixation systems for their aesthetic and functional outcome in the treatment of zygomatic fractures.Twenty-seven patients who required operative reduction and internal fixation for zygomatic fractures were studied in the period from April 2007 to March 2008. Fourteen patients who had fixation with resorbable plate/screws (group A) were compared with 13 patients fixed with titanium plates/screws (group B). The aesthetic outcome was evaluated by an overall self-satisfaction score at 2, 4, and 6 weeks and then at 6 months and 1 year postoperative interval, and the degree of displacement from computed tomographic facial bones were compared preoperatively and 1 year postoperatively. The functional outcome was evaluated by a self-satisfaction scoring system and maximum mouth opening during the same time intervals.The outcome showed that the 2 groups were matched in age, sex ratio, fracture severity, total displacement with 5 sutures, and aesthetic scores preoperatively (P > 0.05). The subjective evaluation by patients for functional satisfaction and overall satisfaction all showed lower satisfaction of absorbable group when compared to titanium group within a postoperative 4-week period, but the satisfaction was similar for both groups after 4 weeks. There was no significant difference between the 2 groups at each measured time period. Postoperative total displacement and aesthetic score demonstrated great improvement in fracture reduction and long-term stability in both groups.There is no significant difference in the outcome between resorbable and titanium plates/screws in fixation of zygomatic fractures. These findings together with the advantages of biodegradable fixation validate its use in fixing these fractures with minimal morbidity.

Zygomatic Fractures

10.1097/sap.0000000000000700

Cite

Citations (18)

Diabetic foot infections with osteomyelitis: efficacy of combined surgical and medical treatment

Diabetic Foot & Ankle (2012)

AbuBakr H. Widatalla Seif ElDin I. Mahadi Mohamed A. Shawer Shadad M. Mahmoud A. E. Abdelmageed

Diabetic foot infections are a high risk for lower extremity amputation in patients with dense peripheral neuropathy and/or peripheral vascular disease. When they present with concomitant osteomyelitis, it poses a great challenge to the surgical and medical teams with continuing debates regarding the treatment strategy. A cohort prospective study conducted between October 2005 and October 2010 included 330 diabetic patients with osteomyelitis mainly involving the forefoot (study group) and 1,808 patients without foot osteomyelitis (control group). Diagnosis of osteomyelitis was based on probing to bone test with bone cultures for microbiological studies and/or repeated plain radiographic findings. Surgical treatment included debridement, sequestrectomy, resections of metatarsal and digital bones, or toe amputation. Antibiotics were started as empirical and modified according to the final culture and sensitivities for all patients. Patients were followed for at least 1 year after wound healing. The mean age of the study group was 56.7 years (SD = 11.4) compared to the control group of 56.3 years (SD = 12.1), while the male to female ratio was 3:1. At initial presentation, 82.1% (n=271) of the study group had an ulcer penetrating the bone or joint level. The most common pathogens were Staphylococcus aureus (33.3%), Pseudomonas aeruginosa (32.2%), and Escherichia coli (22.2%) with an almost similar pattern in the control group. In the study group, wound healing occurred in less than 6 months in 73% of patients compared to 89.9% in the control group. In the study group, 52 patients (15.8%) had a major lower extremity amputation versus 61 in the control group (3.4%) (P=0.001). During the postoperative follow-up visits, 12.1% of patients in each group developed wound recurrence. In conclusion, combined surgical and medical treatment for diabetic foot osteomyelitis can achieve acceptable limb salvage rate and also reduce the duration of time to healing along with the duration of antibiotic treatment and wound recurrence rate.

Debridement (dental)

Concomitant

10.3402/dfa.v3i0.18809

Cite

Citations (40)