114网址导航Sudan: Al Bashir Wins Election As Expected
Sudan: Al Bashir Wins Election As Expected
Written by:
On Monday, the election commission of Sudan announced the victory of Sudanese incumbent present Hassen Omer AlBashir and his National Congress Party (NCP).
The victory of AlBashir was expected since
election started on April 13.
In a press conference, Mukhtar Al-Assam, the chief of the election commission declared that AlBashir won 94.5% of the total cast ballots, which translates to 5 million votes for AlBashir out
of the total 5.5 million votes. AlBashir’s NCP now controls 76% of the 426 seat parliament.
Fadil Shuaib of the Federal Truth Party came next to AlBashir winning 1.4% of the votes.
According to the election commission, only 46% of the 13 million voters cast their votes. The Sudanese election was boycotted by most opposition parties.
African Union observers estimated the turnout around 33%.
In Khartoum, the ruling party’s headquarters witnessed a festive mood with AlBashir’s supporters partying and waving national flags.
According to Gedab News reporter, “only about two thousand people partied while 54%, or 7 million voters, boycotted the election.”
In his victory speech, Sudan mocked his Diaspora opposition by thanking them for the gift they send him: 200 vehicles with their full military gear. His government claimed it has seized the vehicles in its battles with Sudanese rebels.
In a joint statement issued by the USA, UK and Norway, the Troika described the Sudanese election as illegitimate.
Several regions of Sudan are marred by wars and the 71-year-old Al Bashir is not expected to change his approach in trying to resolve the national problems militarily.
The government has been battling rebels in Darfur for the last 12 years and fighting more insurgencies in the Blue Nile state and in Kurdufan since 2011.
There is also a brewing political crisis in Eastern Sudan over power sharing. Eastern Sudan’s Kassala and Port Sudan regions share 605 kilometers long border with Eritrea.
Nearly half the Sudanese population of 37 million live in poverty while unemployment is rampant in the cities.
Related reading:
(April 16, 2015)
If you think the title is blasphemous, not too fast. It is not, and I am hoping you would think&
For the benefit of those who may not know where Senafe is, here is an important synopsis relevant to this&On January 2, 2017, Isaias Afwerki, the Eritrean president, arrived in Abu Dhabi, and held a meeting with the Crown&NEWS RELEASE
FOR IMMEDIATE RELEASE
Friday, December 30, 2016
Contact: Norai M. Ibrahim, Spokesperson and PR Officer Neberai Foundation, Hummed Neberai Scholarships (HNS)
Mr. Sied Mohammed Ali&AngularJS event propagation--siblings? - Stack Overflow
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Stack Overflow works best with JavaScript enabledCitationsSee all >37 ReferencesSee all >2 Figures29.99 · Case Western Reserve University23.23 · University of Western AustraliaAbstractThe broad field of orofacial pain encompasses pain conditions affecting the head, face, neck and intraoral structures. Much has been written about headache specifically affecting adults, but little is known about the presentation of this problem in children. Dentists may be asked to participate in the differential diagnosis or management of headache in young patients. For their benefit, this article discusses the epidemiology, clinical presentation, diagnosis and treatment of headache in this population. An accurate history and careful examination can allow early diagnosis and the avoidance of unnecessary or inappropriate dental procedures.Discover the world's research11+ million members100+ million publications100k+ research projects
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125Clinicalp r a c t i c E Contact AuthorDr. PintoEmail: apinto@dental.upenn.eduHeadache in Children and Adolescents Andres Pinto, DMD, MPH; Maria Arava-Parastatidis, DDS, MS;
Ramesh Balasubramaniam, BDS, MSABSTRACTThe
encompasses
conditions
head, face, neck and intraoral structures. Much has been written about headache specifically affecting adults, but little is known about the presentation of this problem in children. Dentists
participate
differential
management
of headache
young patients.
benefit, this
article discusses the
epidemiology, clinical
presentation,
population.
An accurate history and careful examination can allow early diagnosis and the avoidance of unnecessary or inappropriate dental procedures.Pain is
“unpleasant sensory and emotional experience associated with actual
or potential tissue damage, or de-scribed in terms of such damage.”1 Headaches are
associated
degrees and duration. ?is article discusses headaches in
adolescents,
on primar y
headaches,
migra ine,
tension-type
headache, and
underlying condition.
dental implications
pa-tients who experience neurovascular pain may receive
misdiagnosis
other facial pain.2Primary Headaches MigraineEpidemiologyMigraine is common among
children and adolescents. Its documented prevalence ranges from 0.5%
increases with age.3 –8 Migraine may be associated with other condi-tions. For example, one study reported a 50% prevalence
17-year-old patients
underlying
bony infarctions,
of opioid medications, were suggested as possible causes
relatively
prevalence.10 Migraine
especially
distribution is
a 3:1 ratio between females and males,5,11 which extends
into adulthood. ?e
most common types
experienced
children are migraine without aura and migraine with aura. Childhood periodic syndromes (cyclical vomiting,
benign paroxysmal vertigo of childhood) are common precursors
of migraine and occur
exclusively in the pediatric population.Clinical PresentationMigraine without aura,
previously known as
frequent type
accounting
60%–80% of
migrainous
headaches.12
For citation purposes, the electronic version is the definitive version of this article: www.cda-adc.ca /jcda/vol-75/issue-2/125.html
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Pinto –––experiencing migraine without aura o?en have prodromal symptoms such as changes in
behaviour (e.g., irritability or
decrease in
and appearance
pig-mented macules in the infraorbital region or “dark rings under the eyes”).5 Migraine with aura is characterized by the occurrence of one
more fully reversible
before the onset
of the headache.
child may complain of visual
disturb-ances (visual auras) and hallucinations.13
Somatosensory aura,
paresthe-sias
of the hands
or feet (or
International
Classi?cation
Headache Disorders
diagnostic
criteria for
in Table 1.Diagnosis?e
thorough history
neurologic
examina-tions. ?e dentist has the fundamental knowledge to per-form these procedures and to determine if the facial pain that a child is experiencing corresponds to a migraine or if it has a probable oral component. Taking a pain history for
nevertheless, posing
appropriate
the necessary information.5,11,13?e
examination
blood pres-sure
assessment
hypertension),
evaluation of body temperature
infection) and
meas-urement
circumference
(to exclude
in intracranial pressure resulting from the premature fusion of cranial sutures).15 ?e teeth, ears and sinuses should be examined
of infection.
?e neurologic
examination
assessment
of mental status, consciousness, orientation and
behaviour; a visual examination (to check for blurred or
double vi-sion);
an evaluation
motor Table 1
Diagnostic criteria for migraine in children and adolescents14Migraine without auraA.
At least 5 attacks ful?lling criteria B to DB.
Headache lasting 1 to 72 hC.
Headache having at least 2 of the following:1.
Bilateral location in young children, but may be
unilateral in older children2.
Pulsating quality3.
Moderate or severe intensity of pain4.
Aggravation by or causing avoidance of routine physical activityD.
During the headache at least 1 of the following:1.
Nausea or vomiting2.
Photophobia and phonophobia, which may be
inferred from behaviourE.
Not attributed to another disorderMigraine with auraA.
At least 2 attacks ful?lling criteria B to DB.
Aura consisting of at least 1 of the following,
but no motor weakness:1.
Fully reversible visual symptoms including
positive features or negative features (?ickering lights, spots or lines)2.
Fully reversible sensory symptoms including
positive features (pins and needles) or negative features (numbness)3.
Fully reversible dysphasic speech disturbancesC.
At least 2 of the following:1.
Homonymous visual symptoms or unilateral
sensory symptoms 2.
At least one aura symptom developing gradually over 5 minutes or di?erent aura symptoms
occurring in succession over 5 minutes3.
Each symptom lasting & 5 minutes and
& 60 minutesD.
Not attributed to another disorderBox 1
Questions used in obtaining history of headache1.
Can you describe a typical episode of headache (location, frequency, quality, severity, duration, symptoms)?2.
When did it start? Did it start suddenly?3.
Do you experience symptoms such as visual
disturbances (visual aura) or numbness or
tingling, or both (somatosensory aura)?4.
What makes the pain worse (precipitating factors)?5.
What makes the pain better? Do medications help?6.
What medications have you used in the past?
Did they o?er any relief?7.
Does the headache occur at any particular time of the day?8.
Does the pain interfere with your daily activities?9.
Is there a family history of headaches?10. How is your relationship with your parents,
siblings, teachers and classmates?
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Headache in Children –––coordination
extrem-ities; and an assessment of posture and gait.For most patients with chronic or recurrent headache who
neurologic
examination, no further diagnostic tests are required. However, abnor-malities
discovered
examination
re-ferral to the appropriate medical professional for further diagnostic testing. Abnormal ?ndings might include per-sistent and severe vomiting; changes in behaviour, orien-tation
with coughing, sneezing or lying ? headache that worsens at night or immediately a?er waking; changes to a previous headache pat
and sudden onset of
extremely severe headache.5,16 Treatment Once the diagnosis of migraine has been established, the
an individualized
treatment plan,
incorporating
nonpharmacologic
phar-macologic therapies. Most parents of children who present with symptoms of
underlying
condition is
intra-cranial infection. ?erefore, reassurance as to the benign nature
important aspect
treatment.
Identi?cation
triggers and
preventing
mi-graines.
alterations
sleep patterns
(prolonged
particular
and ingestion
of particular
as chocolate,
cheese, citrus fruits, ca?eine-containing beverages, hot dogs and sausages.13,17,18
Although it
is widely held
that stress
pre-cipitates migraine attacks, this
relationship remains
un-proven.17 Nevertheless,
management
strategies
are used to modify the negative behaviours that may increase the
Biofeedback
relaxation
ther-apies
additional
nonpharmacologic
approaches
that may be e?ective.17 Symptomatic
administered
alleviate pain and relieve symptoms (Table 2). Although the
the treatment
Drug Administration
not approved
children. Nonetheless, preliminary data suggest that the nasal spray sumatriptan is
more e?ective than placebo
chil-dren and adolescents.19, 20 Placebo-controlled studies have shown
signi?cant
improvement
a?er the administration of sumatriptan, and the use of rescue medications
acetaminophen
signi?cantly greater
group.19,20
Unfortunately, side
signi?cantly
patients who
sumatriptan
among those
e?ects Table 2
Symptomatic treatment of pediatric migraineDrug Dose Maximum dose Adverse effects (caution)AnalgesicsAcetaminophen 20 mg/kg PO followed by 10–15 mg/kg every 4 h 75 mg/kg per day HepatotoxicityNephropathyHemolytic anemia?rombocytopeniaIbuprofen 10 mg/kg PO every 4–6 hAge & 12 yr: 200–400 mg PO every 12 h50 mg/kg per day Nausea or vomitingAbdominal painAnorexiaDiarrheaNaproxen 2.5–5 mg/kg ever y 12 h 750 mg/day Nausea or vomitingAbdominal painAnorexiaDiarrheaAntiemeticsPromethazine
Age & 2 yr: 1 mg/kg; can be
repeated at doses of 0.25–1 mg/kg every 4–6 hAge & 2 yr: 25 mg/dose Adolescents: 50 mg/doseDrowsinessConfusionDepressionExtrapyramidal symptomsMetoclopramide 0.1–0.2 mg/kg Children: 0.4–0.8 mg/kg per dayAdolescents: 40 mg/dayDrowsinessFatigueNausea or diarrhea
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Pinto –––were mostly minor, including taste disturbances, nausea, vomiting, “triptan sensation” such as warmth or burning sensation,
paresthesia,
lightheadedness
No di?erence has been
observed between
oral triptans
(sumatriptan,
rizatriptan) and
in terms of clinical improvement
of migraine.19–21 Administration of
medication
phar-macologic
(Table 2). Abuse
of analgesics
discouraged,
medication-overuse
head-ache”), a daily headache related to the frequent use (more than 5 times per week) of analgesics.11 Preventive measures are an option in cases of frequent migraine that interferes with the patient’s daily activities, if
experiences
attacks, for uncommon types of migraine and if the treatment of acute
is ine?ective or has severe side
e?ects.5,2 2 A plethora
agents, such as
antihypertensives, antiepi-leptics and antidepressants, have
been suggested.11,13,16 A more
description
the scope of this paper.Tension-Type HeadacheEpidemiology?e
prevalence
tension-type
ranges from
72.8%.4,6 ,7–9,23
reported prevalence
to variations
in inclusion
criteria and in
variations
of responses
parents during
history-taking.
Tension-type
headache is
adolescents
chil-dren6 and a?ects both sexes equally until the age of 11 or 12.
adolescents,
more common among females.Clinical PresentationChildren and adolescents with tension-type headache report symptoms similar to
migraine (Table 3). Many
precipitating
tension-ty pe
headache have
identi?ed,
environment,
fa-tigue, sleep deprivation and missed meals.2 4 Diagnosis ?e
tension-type
meticulous
and neurologic
examinations.
abnormal ?ndings
examination,
additional
headaches.
In some children,
it may be di?cult to
distinguish between tension-type headache and migraine without aura. In this situation, the “non-migraine” features of the tension-type headache — the quality (pressing
pulsating) and the
the pain, and the
lack of nausea, vomiting, photophobia
and phonophobia, in addition to the fact
not aggravated
to reach the correct diagnosis.TreatmentAs
treat- ment of tension-type
headache must balance
both behav-ioural
interventions
pharmacotherapy.
Nonpharma- cologic treatment begins with reassurance and explanation of the nature of the headache. Since stress is considered a major precipitating factor, steps should be taken to recog-nize and avoid any stress-provoking situations. Sometimes the
identi?ed.
example, the
may describe
of headache on school
days, particularly
examination
and an absence of headaches during vacation times.For treatment of acute headache episodes, an analgesic such as
acetaminophen, ibuprofen and naproxen is o?en all that is required. Acetylsalicylic acid must be avoided, especially for children with signs and symptoms of infec-tion (e.g., varicella, in?uenza), as there is a risk, albeit still disputed, of Reye’s syndrome.25 ?is rare, serious disorder typically begins as a viral infection, most o?en in?uenza or chicken pox. ?e recovery period, which lasts 1–3 days, is
followed by
subsequent
symp-toms of encephalopathy. Le? undiagnosed, the condition progresses to lethargy, confusion and delirium, leading to coma, seizures and death.Prophylactic
instituted
tension-type headache
unresponsive
medication
adminis-tered
neurologist
Diagnostic criteria for chronic tension-type headache13A. Headache occurring on at least 15 days per month for at least 3 months (and at least 180 days per year) and ful?lling criteria B to DB. Headache lasting for hoursC. Headache with at least 2 of the following characteristics:1.
bilateral location2.
pressing or tightening (not pulsating) quality3.
mild or moderate intensity4.
not aggravated by routine physical activity (walking, climbing stairs)D. Both of the following:1.
no more than 1 of photophobia, phonophobia or mild nausea2.
neither moderate or severe nausea nor vomitingE. Not attributed to any other disorderF. Pericranial tenderness on bimanual palpation may be increased
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Headache in Children –––appropriate health care professional to prescribe this kind of treatment. Cluster Headache Cluster
esti-mated prevalence of 0.1%.23 ?is condition tends to occur a?er the
10, although
of earlier
reported,2 6
males. Cluster
characterized
severe pain lasting 15 minutes to 3 hours. ?e pain is unilateral, limited
supraorbital
or temporal
regions, and
accompanied by
ipsilateral
autonomic features
such as conjunctival injection, rhinorrhea, eyelid edema, fore-head
restlessness
agitation.27 Neither
symptomatic
prophylactic
treatments
have been well documented for children and adolescents.Secondary or Organic HeadacheSecondary
attributable
underlying
abnormality
(Box 2).4,14, 27
the clinician
likelihood
primary disorder
evaluation
patient complaining
of headache.
to accurately
identify and
associated
high mortality rate.Obtaining a detailed history is the ?rst step in ruling out
an underlying
di?erential
diagnosis of
persistent
previous trauma, especially in the region of the head and neck, ag-gravation of the headache by activities such as
coughing or
deterioration
a?er waking should arouse suspicion. ?e
clinical and
neuro-logic examinations provide further information. Elevated blood pressure implies pediatric hypertension,28 whereas fever can be a symptom of intracranial infection, such as bacterial meningitis, viral meningoencephalitis and brain abscess, or extracranial infection, including sinusitis and otitis media. Observation of the
skin for scars or bruises may
trauma. ?e neurologic examination should begin as soon
as the child
Interactions
the parents, the
child’s ability to play with toys or draw pic-tures while waiting, and the child’s play behaviour can all provide information
about level
consciousness,
orien-tation
evaluation
young patient complaining
of headache
raises the suspicion
of an underlying disorder, the patient must be referred im-mediately to the appropriate medical specialist.Dental Considerations of Neurovascular Headaches Patients with pain in the distribution of both the ?rst and the second branches of the trigeminal nerve, with or without accompanying pain in the third branch, and who report nausea, photophobia and/or phonophobia o?en re-ceive a diagnosis of migraine.
Conversely, for those with pain
restricted
distribution
and/or mandibular
overlooked.3, 29
cases of migraine con?ned to the distribution of the maxillary and
mandibular
so-called “facial migraine.”2Although
the orbital,
supraorbital
also present
structures
the temporomandibular
of headache
unnecessary
treatment such as extractions or root canal therapies. ?e o
Head and neck traumao
Epidural hematoma (due to trauma)o
Subdural hematoma (due to trauma)o
Bacterial meningitiso
Viral meningoencephalitiso
Brain abscesso
Intracranial neoplasmso
Idiopathic intracranial hypertension
(pseudotumour cerebri)o
Postlumbar puncture headacheo
Sinusitiso
Otitis mediao
Refractory errors (myopia, hyperopia, astigmatism)o
Substance exposure (nitric oxide, carbon
monoxide, food components, alcohol, cocaine,
cannabis, medications)o
Substance withdrawal (ca?eine, opioids, estrogen)o
Hypertensiono
Hypothyroidismo
Hypoglycemiao
Sleep apnea o
Chiari malformation type Io
Arteriovenous malformationBox 2
Causes of secondary headache in children and adolescents
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Pinto –––diagnostic
of cluster
(Table 3) should always
in mind in cases
of pain in the teeth
temporomandibular joint
when there is
evidence of
temporomandibular
disorders.?e
neurovascular
af-fecting
structures
population
does not entail
the nonexistence of this phe-nomenon
in children and
adolescents.
contrary, because
neuroanatomy
pathophysiologic
mech-anisms
of headache
for children
adults, it
reasonable
the intraoral
structures.3 0
information
headache in
children that
is currently
available is inadequate, and it is therefore challenging to make
the correct diagnosis. Nonetheless,
the various orofacial
entities, as
an incorrect
diagnosis may
detrimental
any child with questionable headache and dental or temporo-mandibular
application
noninterven-tional
procedures
clearly invasive
treatments
endodontic
therapy or
extraction.
expertise,
a physician
appropriate
best solution for the patient’s health.Appliance TherapyFew
appliance therapy
In studies of appliance
adult patients with tem-poromandibular disorders and headache, use of an appli-ance was associated with improvement of headache.14,31,32 It
neurovascular
orofacial pain
overlapping
myofascial
components and
multidisciplinary
therapeutic
ap-proaches
neurologists,
therapists and
literature,
treat-ment
temporomandibular disor-ders with a full-coverage appliance may reduce headache frequency. However, to our knowledge, the use of an oral appliance
the treatment
pediatric population
never been studied;
therefore,
we advise caution in using appliances in this setting. aTHE AUTHORSDr. Pinto is an
professor of oral
medicine and dir-ector
Oral Medicine
Clinical Centre
University of Pennsylvania School of Dental Medicine. He
uni-versity
Children’s Hospital
of Philadelphia, Pennsylvania.Dr.
Arava-Parastatidis
University
Pennsylvania
Medicine, Philadelphia, Penn sylvania.Dr. Balasubramaniam is co-director of
the Perth Orofacial Pain
Hospital, Subiaco,
Australia,
Australia,
lec-turer,
of Dentistry, University
Australia, Nedlands, Western Australia, Australia.Correspondence
University
Pennsylvania
of Dental Medicine, Robert
40th Street, Suite 214, Philadelphia, PA 19104.?e authors have no declared ?nancial interests.?is article has been peer reviewed.References1. Pain terms: a list with
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pilot study. Swed Dent J 200 4; 28(1):11–20.–––
Headache in Children –––
Full-text · Article · Sep 2009 +5 more authors ... Full-text · Article · Jan 2011 +3 more authors ...ABSTRACT: The aim is to describe our former experience in clinical evaluation and usage of diagnostic criteria according to the International Classification of Headache Disorders, 2 nd Edition, in children with headache. Clinical documentation of patients hospitalized at Department of Neuropediatrics, Sestre milosrdnice University Hospital in Zagreb from January 1, 2003 until December 31, 2007 was retrospectively analyzed. The study included 377 children: 58.6% girls and 41.4% boys, mean age 11 years and 8 89.7% of patients were hospitalized for the first time due to headache. First-ever headache was present in 40.1% and recurrent in 59.9% of patients. Headache occurring for more than 3 months was present in 61.6% of patients. Headaches were classified on the basis of history, physical findings, neurologic status and diagnostic results, as follows: tension-type 36.1%, probable tension-type 5.6%, associated with pathologic changes of extracerebral cranial structures 20.7%, migraines 16.7%, post-traumatic 3.2%, intracranial non-vascular 1.8% and vascular 0.3%, associated with infection 0.8% or disorders of homeostasis 0.5%, and other causes 14.3%. In conclusion, tension-type headache was most common. In order to evaluate the etiological factors that require specific therapy, we recommend detailed clinical evaluation of children with headache duration for more than 3 months.Article · Apr 2011 +3 more authors ...ArticleJanuary 2017 · Revista espa?ola de estomatologíaConference PaperJanuary 2017+2 more authors…ArticleJanuary 2017 · Journal of the American Dental Association (1939) · Impact Factor: 2.01ArticleJanuary 2017 · The Clinical journal of pain · Impact Factor: 2.53+2 more authors…Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.This publication is from a journal that may support self archiving.Last Updated: 13 Aug 16
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