Background: Disorders of sex development (DSD) comprise a group of congenital conditions characterized by atypical chromosomal, gonadal, and anatomic sex development. The birth of a child with these disorders considered a medical and psychosocial emergency. Objective: The aim of this study was to see the prevalence, etiological factors, management, and problems faced in handling these cases. Methods: This is a descriptive retrospective study was conducted at Soba university hospital including all patients with proved DSD over a 6-year period. Results: One hundred thirty-six cases were seen, of which 40 were included in the study. The median age at presentation was 3 years. The most common cause of XX DSD was congenital adrenal hyperplasia (72.5%) and that of XY DSD was androgen insensitivity syndrome. Eleven patients (27.5 %) needed sex reassignment. There was a preference for the male sex. Conclusion: DSDs are not uncommon in Sudan. Because of lack of awareness and sociocultural reasons cases are referred late. Multidisciplinary teams have to be trained to make services accessible and affordable. Keywords: Children; Disorders of Sex Development; Sudan.

<p><strong>Background:</strong> Locally advanced rectal cancer can be down staged by neoadjuvant therapy and the resultant tumor response can be quantified histologically.</p><p><strong>Objective:</strong> This study aimed to assess pathologic response of neoadjuvant chemoradiation in patients with locally advanced rectal cancers treated in Wad Medani Teaching Hospital (WMTH) and National Cancer Institute (NCI), Wad Medani, Sudan.</p><p><strong>Patients and Methods:</strong> A total of 36 consecutive patients with locally advanced rectal cancer that were managed in WMTH and NCI during the period from 2006-2011 were reviewed. Preoperative pelvic radiotherapy was delivered.  The total of 46 Grays were delivered concurrently with 5- fluorouracil (5-FU) on the first and last week of radiation. Total mesorectal excision of the rectal tumour either by anterior or abdominoperineal resections was planned at 6-8 weeks from completion of preoperative treatment. The pathological response to therapy was assessed by histopathology examination of the surgical specimen.</p><p><strong>Results:</strong> Initial clinical staging of patients revealed 58.3% of them were stage T3/T4N2M0 and 41.7% were stage T3N0M0. Down-staging to stage T1/T2N0M0 was found in 36.1% and stages T3N0M0 in 30.6%. No response was seen in 8.3% of cases with stage T3/T4N2M0 while a complete clinical response (no residual) was seen in 25.0%. Complete histological response was observed 13.8%. Positive lymph-nodes metastasis was confirmed in 8.3% of cases.</p><p><strong>Conclusion:</strong> Neoadjuvant chemoradiation is a reasonable option for cases of rectal cancer and deserves further evaluation.</p>

Background: Locally advanced rectal cancer can be down staged by neoadjuvant therapy and the resultant tumor response can be quantified histologically. This study aimed to assess pathological response of neoadjuvant chemoradiation in patients with locally advanced rectal cancers treated in Wad Medani Teaching Hospital (WMTH) and National Cancer Institute (NCI), Wad Medani, Sudan. Patients and methods: A total of 36 consecutive patients with locally advanced rectal cancer that were managed in WMTH and NCI during the period from 2006-2011 were reviewed. Preoperative pelvic radiotherapy was delivered. Total of 46 Gray were delivered concurrently with 5-fluorouracil (5-FU) on the first and last week of radiation. Total mesorectal excision of the rectal tumour either by anterior or abdominoperineal resections was planned at 6-8 weeks from completion of preoperative treatment. The pathological response to therapy was assessed by histopathology examination of the surgical specimen. Results: Initial clinical staging of patients revealed 58.3% of them were stage T3/T4N2M0 and 41.7% were stage T3N0M0. Down-staging to stage T1/T2N0M0 was found in 36.1% and stage T3N0M0 in 30.6%. No response was seen in 8.3% of cases with stage T3/T4N2M0 while complete clinical response (no residual) was seen in 25.0%. Complete histological response was observed in 13.8%. Positive lymph-nodes metastasis was confirmed in 8.3% of cases. Conclusion: Neoadjuvant chemoradiation is a reasonable option for cases of rectal cancer and deserves further evaluation.