Medicine

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A look into the correlation between Major Depressive Disorder (MDD) and physical activity
(International Journal of Research Publications (IJRP.ORG), 2022) Hassan I. Osman; Shahd Salaheldeen
Depression is an issue that faces humanity. It carries a high suicide rate as well as a very high morbidity rate. Combating depression is a deed that is bestowed upon metal health workers. A plethora of approaches to depression exist. Many of them being pharmaceutical in nature. The authors of this paper understand that these options are not always available to everyone and, ergo, decided to conduct a review article which explores the effects of exercise on depression. This research has showed that physical activity has significant positive effects on mental health in general (namely, depression and anxiety). This effect seems rather comparable to that of SSRIs. This is of importance as it illustrates the need for the immediate implementation of physical activity in their treatment modules to combat depression in our mental health institutes.
A review on SARS-CoV-2: the origin, taxonomy, transmission, diagnosis, clinical manifestations, treatment and prophylaxis
(2020-01-11) Hilmi Zahir Abbas; Aloufi Bandar H; Ibrahim Husam MA
Coronavirus disease 19 (COVID-19) pandemic, caused by highly contagious SARS-CoV-2 that infects the respiratory system. COVID-19 started in Wuhan, south China, in December 2019, and spread to all other parts of the world. SARS-CoV-2 has +ssRNA genome (29,844bp) enclosed in an enveloped capsule (60 to 140 nm) and showing high genome homology (96%) with coronavirus of its potential natural reservoir Horseshoe bats. Two types of SARS-CoV-2 were detected: type L (70%) and type S (30%). SARS-CoV-2 spikes have very high binding affinity with all cells expressing ACE2 receptor. Nasal swabs and bronchoalveolar lavage samples were used by reverse transcriptase rtPCR for detection of SARS-CoV-2. ELISA can detect anti-SARS-CoV-2 IgM and IgG antibodies five days post infection. COVID-19 infection is confirmed by clinical signs and symptoms and CT thoracic images. Patients typically present with fever (87.3%), cough (58.1%), dyspnea (38.3%), muscle soreness or fatigue (35.5%), chest distress (31.2%) and expectoration (29.4%). The fatality rate of the infection approaches 7%. Hundreds of lungs micro clots were reported to occur causing heart failure and death. Fatal consequences were reported in older patients and those with chronic diseases. There is no specific medicine, but supportive treatment and anticoagulants are in use. Chloroquine and azithromycin have fatal consequences in 50% of patients, while Remdesivir did not show significant clinical or antiviral effects. Plasma convalescence clear the infection within three days. There is no vaccine for SARS-CoV-2 due to its mutations. Social isolation and countries lockdown measures exert catastrophic negative impact on health and economy worldwide.
Active Tuberculous Infection among Adult Sudanese Patients on Long Term Peritoneal Dialysis
(2012-09) Hasan Abu-Aisha; Mazin Shigidi; Nazik Farouk; Ramy Ibrahim Abulikailik; Rabab Tag Alsir
Introduction: The prevalence of tuberculosis in Sudan is 209 cases per 100,000 populations. There are no reports available regarding the prevalence of tuberculosis among the end-stage kidney disease and dialysis populations. Methods: We reviewed the medical records of all adults who were on peritoneal dialysis (PD) in the Sudan Peritoneal Dialysis Program, during the period from June 2005 to December 2011. Those diagnosed as having active tuberculous infections were retrospectively studied regarding their demography, clinical presentation and outcomes. Results: Out of 350 patients in our program, 19 were diagnosed as having active tuberculosis (5.4%). All patients were diagnosed during their first year on peritoneal dialysis, 74% were males; the mean age was 37 ± 11 years, extrapulmonary tuberculosis was seen in 16/19 (84%) patients and it was abdominal in nine of the 16 (47%) patients. In addition to high clinical suspicion, the diagnosis of active tuberculosis was supported by tissue biopsy findings in 16%, positive polymerase chain reaction in 26%, exudative ascites with suggestive radiological features in 21%, strongly positive tuberculin test in 21% and a favourable response to empirical antituberculous therapy in 26% of patients. HIV test was negative in all 19 patients and only one patient tested positive for hepatitis B viral infection. Antituberculous drugs side effects were seen in 68% of patients. Forty seven percent of patients showed complete recovery and continued on peritoneal dialysis. Our case fatality was 32%. Conclusion: Abdominal tuberculosis is common among PD patients and its diagnosis should always be considered in suspected patients.
Alien Hand Syndrome: Introduction, l iterature review and overview
(Napata College, 2022) Hassan I. Osman; Rudaina I. Osman
Few disorders/syndromes are surrounded by as much mystery as Aline Hand Syndrome (AHS) – a rare neurological disorder of connection which ergo results in misinterpretation and a loss of ownership of a limb (usually upper). In this paper, we aim to bring forth enough light on AHS so that more clinicians can correctly diagnose AHS, research efforts increase and awareness. It is, undoubtedly, misdiagnosed en masse on a daily basis as a result of our failure to properly introduce it in medical literature. A phenomenon of which we have a fair amount of understanding, yet have yet to teach it in medical references. In our search for AHS in medical references, we came across a total of only 1 reference which discussed AHS. It is important that we note that the number of references we searched was 16 and that these were well-known references which medical students and practitioners read on a daily basis all around the globe.
An overview of aortic stenosis (AS): what we know and when should we intervene?
(International Journal of Research, 2021) Rudaina I. Osman; Hassan I. Osman; MBBS
Introduction: A condition in which there is a continuous state of fibrosis, thickening as well as calcification of the leaflets that’ll eventually impede the amount of blood reaching the heart, which, if left untreated/maltreated, will eventually lead to death (1). AS does not only have an impact on the aforementioned valve, but on the LV and the entirety of the systemic vasculature (2). The most commonly encountered heart valve lesion, AS is believed to affect 2- 5% of older adults (3). It is estimated that 4-7% of individuals aged 65 years or older have been diagnosed with severe AS (3). Etiology of AS: It is believed that there are 3 major causes of AS, these are: 1) Degenerative (Calcific), 2) Rheumatic (4,5), and 3) Congenital Clinical Manifestations & Underlying Etiology: First articulated in 1968 by Ross and Braunwald (8), it is now commonly accepted amongst professionals that the development of symptoms (such as exertional dyspnea, angina, and syncope) is a poor prognostic sign as it clearly signifies left ventricular decompensation (1,8). Diagnosis: The diagnosis of calcific aortic stenosis is initially suspected if a systolic ejection murmur is present; be that as it may, the clinically significant question is normally whether the aortic stenosis is to be classified as ‘severe’ (5). The three most useful signs when it comes to diagnosing severe aortic stenosis are: 1) Late peaking systolic murmur, 2) Single second heart sound or paradoxical splitting of S2, and 3) ‘cooing’ murmur (5). Current guideline-recommended treatment strategies and their limitations: In a general sense, contemporary clinical rules suggest aortic valve intervention when stenosis seriousness is considered extreme and there is confirmation of left ventricular decompensation, via the direct even-handed or proxy representative measures (1). Conclusion: Aortic stenosis is a common cardiac disease that is of the upmost importance, deserves our undivided attention, and a crucial part in decreasing any morbidity and mortality is generally through a very careful follow-up. The gold standard investigation for suspected cases is echocardiography (5), currently the only treatment available would be a valve replacement therapy which is proven to have a good outcome and increases the patient’s life span (4). In asymptomatic patients on the other hand aortic valve replacement is considered only after symptoms have developed or if the exercise test results are worrying (4,14). We are hoping that in the future there’ll be more treatment options available that would suit the different ages and health statuses of the patients. Recommendations: 1) The initiation, funding, and publication of further studies on AS, ergo permitting for decreased morbidity and mortality, 2)The initiation of awareness programs amongst the public that would result in a decreased likelihood of lifestyle-caused AS, 3) The initiation of awareness programs amongst the public that would result in patients being overall better surgical candidates if it must take place, 4) The initiation of nation-wide (in Sudan and elsewhere around the world) geriatric services that would result in the monitoring of those most likely to fall ill with AS.
Aquaporin 5 promotes tumor migration and angiogenesis in non‑small cell lung cancer cell line H1299
(Elkhider, 2020-01-07) Abdalkhalig Elkhider; Bing Wang; Xunli Ouyang; Mahmoud AL‑Azab; Williams Walana; Xiaotong Sun; Han Li; Yawei Tang; Jing Wei; Xia Li
Non‑small cell lung cancer (NSCLC) constitutes the majority of all lung‑cancer cases. Aquaporin 5 (AQP5) may be involved in NSCLC by promoting lung‑cancer initiation and progression. The present study aimed to determine the role of AQP5 in migration and angiogenesis using NSCLC cells and HUVECs. AQPs 1, 3, 4, 5, 8 and 9 were screened in the NSCLC cell line H1299, and the present results showed that AQP5 mRNA was upregulated compared with the other AQP genes. At the protein level, AQP5 was significantly increased in H1299 cells compared with 16HBE cells. AQP5 knockdown in H1299 cells significantly decreased cell migration compared with untransfected cells, as demonstrated by both Transwell and wound closure assays. The present study further investigated H1299 ability to promote HUVEC vascularisation. The supernatants of both transfected and untransfected H1299 cells were used as conditioned medium for HUVECs, and tube formation was measured. The supernatant of AQP5‑downregulated cells exhibited significantly low tube formation potential compared with untransfected cells. Similarly, vascular endothelial growth factor was significantly increased in control cells (si‑NC) compared with cells transfected with small interfering RNA targeting AQP5. The present study found that AQP5 downregulation significantly decreased the phosphorylation level of epidermal growth factor receptor and the activity of the ERK1/2 pathway. In summary, the present study suggested that AQP5 influenced migration and angiogenesis in NSCLCs in vitro and may potentially exhibit similar in vivo effects.
Arabic Translation, Adaptation, and Validation of The Kidney Disease Quality of Life Short-Form 36
(Saudi Center for Organ Transplantation, 2019) Hasan Abu-Aisha; Sarra Elamin; Abdelbagi H. E. Elbasher; Shima E. E. Ali
The Kidney Disease Quality of Life Short Form 36 (KDQOL-36) is a self-reported measure of health for patients with chronic kidney disease. Our goal was to develop an Arabic version of KDQOL-36 that is linguistically and conceptually equivalent to the original English version. We translated KDQOL-36 into formal Arabic language using forward and backward translation. To assess conceptual equivalence, we administered the Arabic and English versions simultaneously to a group of 10 bilingual patients. To assess test–re-test reliability, we administered the instrument twice to a group of 10 hemodialysis (HD) patients. To assess internal reliability, convergent validity, and discriminate validity, we administered the instrument to 62 HD patients and 82 kidney transplant patients asking them to simultaneously fill the Depression, Anxiety and Stress Scale (DASS-21). The intraclass correlation coefficient (ICC) between the Arabic and English versions indicated excellent conceptual equivalence. The ICC between test and re-test scores revealed good reliability in the burden of kidney disease subscale and excellent reliability in the remaining four subscales. The translated version of KDQOL-36 had a Cronbach’s alpha of 0.81, indicating good internal reliability. We found significant negative correlations between the five subscales of the instrument and DASS-21, indicating good convergent validity. Kidney transplant recipients had significantly better scores than HD patients in the five subscales of the instrument, indicating excellent discriminate validity. The current Arabic version of KDQOL-36 has excellent conceptual equivalence with the original English version. It is a reliable and valid instrument for Arab kidney disease patients.
Chronic Kidney Disease in Police Forces Households in Khartoum, Sudan: Pilot Report
(2009-05) Hasan Abu-Aisha; Elwaleed AM Elhassan; Ammar Hasan Khamis; Adil Abu-Elmaali
Introduction: In the Police Forces Hypertension, Diabetes, Renal Insufficiency and Thyroid Derangement (HyDRIT) pilot study we explored the prevalence, risk factors, awareness, treatment adequacy and complications of chronic kidney disease (CKD) and other non-communicable diseases among adult Police Forces households in two housing complexes in Khartoum, Sudan. Methods: Serum creatinine measurements and urine dipstick testing were performed for 273 individuals. The glomerular filtration rate (GFR) was estimated using the standardized Cockroft-Gault and the four variable MDRD formulas. CKD was defined as an estimated GFR of less than 60 ml/min/1.73m2 and/or proteinuria. Results: The overall prevalence of CKD was 11% (30/273) using the standardized Cockroft-Gault equation and 7.7% (21/273) using the four variable MDRD equation. According to the standardized Cockroft-Gault formula, 14 subjects had reduced GFR with negative urine dipstick testing, two subjects had both proteinuria and reduced GFR, and 14 subjects had proteinuria without reduction in GFR. None of those subjects was aware of his kidney problem. According to the standardized Cockroft-Gault formula, 14 of the identified CKD cases were hypertensive (46.7%); eight of them (57.1%) had a prior diagnosis of hypertension but none achieved therapeutic targets. Four of the identified CKD cases were diabetic (13.3%), three of whom had a prior diagnosis of diabetes mellitus with reasonably controlled blood sugar levels. Only age above 50 years and low educational level proved to be independent risk factors for CKD in multivariate analysis. Conclusion: The prevalence of CKD in the study population seems to be comparable to other countries.
Correlations of complete blood count, liver enzyme and serum uric Acid in Sudanese pre-eclamptic cases
(2018-04) Hind M. Beheiry; Ibrahim A. Ali; Mazin S. Abdalla; Ahmed M. Sharif; Amal M. Saeed
Background: Pre-eclampsia is a serious disorder of pregnancy with unknown ethological factors that may occur at any stage of second or third trimester of pregnancy. The objectives of the present study were to assess changes in complete blood counts including platelets, liver enzymes and serum uric acid in pre-eclamptic cases compared to second-half normal pregnant and non-pregnant Sudanese women and their correlations to other biomarkers. Methods: This was a cross-sectional, case-control study performed from December 2008 to December 2010; in Omdurman Maternity Hospital, in concomitance with other studies in pre-eclampsia. The sample size included three groups, 72 up pre-eclamptic cases in their recent pregnancies, 96 normal pregnant in their second half of pregnancy and 63 non- pregnant (control) women; a total of 231 subjects. Questionnaire Interviews and clinical examination were done for all participants. Laboratory investigations were done including complete blood picture, liver enzymes and uric acid. Results: The mean Hb concentration of the pre-eclamptic (11.3g/dl±1.7) was statistically significantly lower than that of the non-pregnant (12.1g/dl±0.2) (P=0.01) but not from that of the normal pregnant (11.4g/dl±0.1) (P=0.882) .There was no statistical significant difference in the mean WBC count between the pre-eclamptic (7.4x103/mm3±0.3) and non-pregnant (7.3x103/mm3±0.3) (P=0.797) and between the pre-eclamptic and normal pregnant (7.7x103/mm3±0.2) (P=0.270). There was a considerable statistical significant decrease in the mean platelets count of the pre-eclamptic (236.4/mm3±8.3) compared to the non-pregnant group (322.0/mm3±10.4) (P=0.0001) s well as to the normal pregnant (275.0/mm3±8.9) (P = 0.003). In the pre-eclamptic cases, serum ALT correlated significantly with TWCC (r=0.26, P=0.03) and serum AST (r=0.65, P=0.000). In the pre-eclamptic cases, serum AST correlated significantly with Hb (r=0.26, P=0.03), serum ALT and serum uric acid (r=0.36, P=0.01). Conclusions: There was a considerable statistical significant decrease in mean platelets count of the pre-eclamptic compared to the non-pregnant group and to the normal pregnant may be explained by hemodilution; whereas further decrease was due to pre-eclampsia. ALT and AST are strong prognostic indicators of pre-eclampsia.
COVID-19: How long does it last?
(JRP.ORG, 2021) Hassan I. Osman; MBBS
COVID-19 has taken the world by storm ever since it first appeared in Wuhan, China back in late 2019. In this paper, we observed a phenomenon that has lately manifested in regards to COVID-19 – that being Long-haul COVID, an illness in which COVID-19 symptoms keep manifesting in patients despite the illness having exceeded its expected course. Findings were rather intriguing; the phenomenon has manifested itself in a plethora of manners which are all discussed in the paper. Furthermore, it is important that we note that the phenomenon is poorly studied and is in need of further exploring. We, at Napata Research Innovation Center pledge to set forth and lead, to the best of our capability, the research efforts in regards to COVID-19 and this newly discussed phenomenon.
Detection of Mucosal HPVs, HPV16 and HPV18 in Cervical Squamous Cell Carcinomas in Sudan
(AENSI, 2014-08-29) Zahir A. Hilmi; Nusiaba H. Abdo; Bandar H. Aloufi; Suheir R. Rehan; Yousif; F. Hamedelnil; Husam; M. Abdallatif
Background: Human papillomavirus (HPV) is the principal etiology for cervical cancer. Few contradictory researches were published in Sudan. Objectives: This research aimed to explore the roles of HPV16 and HPV18 in cervical cancer in Sudan.Materials and Methods: The DNA was extracted from sections of paraffin embedded tissues of Sudanese women (n, 63) with oral squamous cell carcinomas and controls (n, 17). The patients DNA samples (100ng/μl) were amplified by mucosal HPV GP5+/GP6+, HPV16 type specific and HPV18 type specific primers. Results: GP primers detected mucosal HPVs in 75% (n, 47) of the patients, and none of the controls. HPV16 and HPV18 types were identified from 70% (n, 33) and 9% (n, 4) of the GP positives. HPV16 was identified from all tumor differentiations degrees specially moderately differentiated tumors, while HPV18 was identified from moderate and well differentiated tumors. HPV16 was isolated from all ages but mostly isolated from older patients, while HPV18 was isolated from younger patients. Ten unknown mucosal HPV types were detected. HPV16 and HPV18 were mostly detected in house wives ethnically from Central Sudan. Conclusion: HPV 16 is the most important determinant for development of cervical cancer in Sudan, with less contribution of HPV18. HPV screening and vaccination program has to be established in young Sudanese women.
Determination of fat composition in the meats of tilapia and Nile perch fishes collected from Blue Nile and White Nile, Sudan
(2022-04-11) Zahir Abbas Hilmi; Tahany Abdel Gader El Shareef Malik; Yasir Mohamed Abdelrahim; Ayda Ali Khalifa; Mutaman Ali A Kehail
Fish provides a good source of high quality protein and contains many of fat-soluble vitamins (A, D, E and K), mineral elements and antioxidant. This study determined the fat composition in the meats of two popular fish species that were brought from the fish market of Wad Medani City (Blue Nile samples; BN), and from Kosti fish market (White Nile samples, WN). The preparation of fish meat-fat and fat composition (through GC-MS), were run in the Food Analysis Laboratory, and the Central Laboratory - University of Gezira. The results showed that, Hexadecanoic acid was detected in WN Nile Perch (3.01%) and Tilapia (13.37%), whereas BN samples did not contain this fatty acid. Eicosanoic acid appeared in only BN samples: Tilapia (9.60%) and perch (2.12), Oleic acid (omega 9) appeared only in WN samples (it was 4.01% in NP, and 16.54% in T. Octadecanoic acid (Streaic acid) was appeared in all BN and WN samples (it was 8.45% in BN Perch, 1.6% in BN Tilapia, 1.60% in WN Tilapia and 0.29% in WN Perch). The more abundant fatty acids was Oleic acid (total sum 20.55%), then Hexadecanoic acid (16.38%). From the proposed results, the feasibility of local production of fish oils for human consumption should be done.
Determination of some nutrient minerals in the meats of three species of fishes brought from the Blue Nile and the White Nile, Sudan
(2022-04-11) Zahir Abbas Hilmi; Tahany Abdel Gader El Shareef Malik; Yasir Mohamed Abdelrahim; TAyda Ali Khalifa; Mutaman Ali A. Kehail
Various fish species are found in fish-markets that trigger the need to evaluate the quality of various fish meat products to answer the consumer needs. This study evaluated some mineral elements in the meats of Baiad (B), Tilapia (T) and Nile Perch (NP) fish species. These fish species were brought from the fish market of Wad Medani City (Blue Nile Fishes; BN), and from Kosti fish market (White Nile Fishes; WN). The preparation of fish meat-ashes and the determination of minerals (through Atomic Absorption), were run in the Food Analysis Laboratory, and the Central Laboratory - University of Gezira. The results showed high concentration of Cu element in WN samples was high in B-meat (0.434 mg/L) and in BN sample in T-meat (0.115 mg/L). Mn element in WN samples was high in B-meat (0.282 mg/L) and in BN sample in T-meat (0.292 mg/L). Fe (0.788 mg/L) and Zn (0.950 mg/L) elements were high in NP-meat of WN, while Fe (3.261 mg/L) and Zn (5.123 mg/L) were high in B-meat of BN. WN samples were highly contaminated with Pb which was about 24-folds more than the maximum tolerable limit (0.025 mg/L), while BN samples were still about third that standard. It was cleared that, BN fish samples were relatively rich in Fe and Zn, while WN samples were relatively rich in Cu and Mn elements.The contamination of fish meat of WN with Pb should be seriously studied, and the meat quality of all fish species should be determined.
Educational Challenges, Obstacles and Critical Incidents in Problem Base Learning (PBL) Tutorial Group
(2017-11-30) Ibrahim A Ali; Mazin. S. Abdalla; Ahmed T. Abdalla; Omnia T. Abdalla
Since the dawn of the era of innovation, the need for novel methods in making life easier has been interminable. The learning process shows no exceptions to this rule. One would argue for the classic methods in handling the trade of information between the teacher and the students, which has been unilateral. The introduction of problem based learning (PBL) process to the system of education is facing many struggles. In this student-centered active learning process, the teacher is just a guide focal point of education systems. Literature search strategy included electronic database searches, internet searches, hand searching, ancestry searching and networking. Objectives: The objective of this review article is to study the challenges, obstacles and critical incident in PBL tutorial groups. Problem base learning model is counteracting by a lot of educational, financial and psychological challenges and barriers. Keywords: PBL, student center learning, real problem, active learning
Educational Management, Educational Administration and Educational Leadership: Definitions and General concepts
(Scholars Academic and Scientific, 2017-12-30) Ibrahim A Ali; Mazin S. Abdalla
For an educational system, or any system for that matter, the terms which lift the weight are management and leadership. By the dawn of the past century, much attention has been given to these two terms for their magnitude of importance and implication. When it comes to the educational facility and the question of allocating the available resources to achieve the maximum goals, it becomes crystal clear that a figure with influence is needed in the educational playground, so to speak. This review shed some light on these points and illustrates their use.
EFFECT OF THE PATIENT’S KNOWLEDGE ON PERITONITIS RATES IN PERITONEAL DIALYSIS
(International Society for Peritoneal Dialysis, 2013-07) Hasan Abu-Aisha; Suheir A.M. Sayed; Magda E. Ahmed; Sarra Elamin
Introduction: After a training period, patients maintained on continuous ambulatory peritoneal dialysis (CAPD) assume responsibility for their own treatment. With the aid of appropriate tools, home visits help with ongoing evaluation and training for these patients. ♦ Methods: We conducted a home visit survey of 50 patients maintained on CAPD in Sudan between April 2009 and June 2010. Housing conditions, home environment, and patient’s or caregiver’s knowledge about peritoneal dialysis and the exchange procedure were evaluated using structured data collection sheets. Scores were compared with infection rates in the patients before the home visit. ♦ Results: Patients were maintained on CAPD for a median duration of 11 months. Their mean age was 42 ± 23 years; 70% were male; and 14% had diabetes. Only 34% of patients had suitable housing conditions, and 56% required assisted PD. Of the autonomous patients and assisting family members, 11.6% were illiterate. The median achieved knowledge score was 11.5 of 35 points. The median achieved exchange score was 15 of 20 points. Knowledge and exchange scores were positively and significantly correlated (R = 0.5, p = 0.00). More patients in the upper quartile than in the middle and lower quartiles of knowledge scores were adherent to daily exit-site care (33.3% vs 5.3%, p = 0.02). Compared with patients in the middle and lower quartiles of knowledge score, patients in the upper quartile had lower rates of peritonitis, exit-site infection, and hospitalization. ♦ Conclusions: The proposed evaluation form is a valid and reliable assessment tool for the follow-up of CAPD patients. Patients in the upper quartile of knowledge score demonstrated better adherence to the recommended treatment protocols and lower infection rates.
EFFICACY OF ONCE-DAILY AMLODIPINE IN THE CONTROL OF 24-HOUR BLOOD PRESSURE USING AMBULATORY BLOOD PRESSURE MONITORING
(1995-11-11) Hasan Abu-Aisha; SAMEER HURAIB; AKRAM ASKAR; JAMAL AL-WAKEEL; AHMAD MITWALLI; SULIMAN AL-MAJED
To evaluate the efficacy, tolerance, and acceptance of once-daily amlodipine in the control of 24-hour blood pressure (BP), we conducted an open-label, uncontrolled trial in 20 patients (17 men and 3 women) with mild-to-moderate hypertension and without evidence of secondary hypertension except as a result of nephropathy. A 2-week washout placebo period was followed by a 12-week period of active treatment. The starting dose of amiodipine was 5 mg once daily; this was increased to 10 mg once daily if BP was not controlled within 6 weeks of starting treatment. Clinic and ambulatory BP measurements were obtained before starting active treatment (week 0) and then at 6 and 12 weeks after the start of treatment. The mean age (±SD) was 49.2 ± 13.7 years. Mean clinic systolic BP fell from 162.4 ± 15.4 mm Hg at week 0 to 136.8 ± 8.7 mm Hg at week 12. Clinic diastolic BP fell from 102.8 ± 5.1 mm Hg at week 0 to 81.3 ± 6.1 mm Hg at week 12, Ambulatory systolic BP fell from 147.8 ± 8.8 mm Hg at week 0 to 136.0 ± 10.6 mm Hg at week 12. Ambulatory diastolic BP fell from 90.4 ± 4.5 mm Hg at week 0 to 81.0 ± 5.0 mm Hg at week 12. There was a significant reduction in systolic BP between week 0 and week 6 (P -- 0.0001), as well as between week 0 and week 12 (P = 0.0008). Similarly, significant reductions were obtained in diastolic BP between week 0 and week 6 (P = 0.0002), as well as between week 0 and week 12 (P = 0.001). The drug amlodipine was well tolerated and well accepted by patients. The results indicate that monotherapy with amlodipine 5 mg once daily is effective in controlling BP over a 24-hour period.
Encysted Fluid Collections after Catheter Removal for Peritonitis in Peritoneal Dialysis Patients
(2008) Hasan Abu-Aisha; Elwaleed A M Elhassan; Maha A Hummeida; Osman-mahir M A Mahir; Hisham M Ali; Aymun I Mobarak; Jamal Abdel-Raheem; Um-Alhasan Mohamed; Hassan A Musa
Introduction: Peritonitis is a frequent complication of continuous ambulatory peritoneal dialysis (CAPD). This case series describes episodes of peritoneal dialysis (PD) related fungal or Pseudomonas peritonitis that were complicated by the formation of encysted intra abdominal fluid collections despite prompt catheter removal and appropriate therapy. Case series: The first patient presented with fever and abdominal pain two weeks after removing his PD catheter because of fungal peritonitis. Examination revealed fluid collection in the former catheter tunnel. This turned out to be pus on surgical drainage. Abdominal computed tomography (CT) scan revealed another extensive encysted extra-peritoneal fluid collection that was aspirated and found to be clear transudate fluid. The second patient presented with abdominal pain and distention seven weeks after removing her PD catheter because of fungal peritonitis. She had a large intra abdominal encysted fluid collection that was drained under ultra sound guidance. The third patient presented with painless abdominal distention one month after removing the PD catheter because of Pseudomonas peritonitis. He had two encysted extra peritoneal fluid collections that were aspirated under ultra sound guidance. This occurred despite three weeks of treatment with oral fluconazole in the case of the first two patients and appropriate antibiotic therapy in the case of the third patient. Conclusion: In fungal and Pseudomonas peritonitis, other measures besides immediate initiation of appropriate therapy and prompt removal of the catheter may be necessary to prevent such late complications. Suggested measures include continued intraperitoneal antibiotics by a fresh PD catheter, in addition to systemic antifungal treatment
Ethnic distribution and clinical features of systemic lupus erythematosus in the Sudan
(2009-05) Hasan Abu-Aisha; Babikir G Kaballo; Abubakr A Wahab; Musa M Nur; Karar A Modawi; Elnazir EM; Omer H
Background Systemic lupus erythematosus (SLE) is a multisystem chronic inflammatory autoimmune disease characterized by periods of remissions and relapses. It is thought to develop when genetically predisposed individuals are exposed to one or more environmental triggers. The ethnically mixed population of the Sudan offers an opportunity to look into the effect of ethnicity on the distribution and systemic expression of the disease. Patients and methods Eighty seven consecutive patients fulfilling the clinical and laboratory criteria for the diagnosis of SLE were prospectively interviewed and examined using a unified protocol in three medical clinics in different parts of Khartoum. Appropriate investigations, including renal biopsies were carried out when indicated. Results Eighty three of the 87 patients (95.4%) were females (female to male ratio 20.6:1). Mean age at diagnosis was 31.89 years (range 21- 30). The disease was most frequently seen in tribes of mixed ethnicity (Afro-Arabs) and least common in pure African tribes. Thus, subjects with Afro-Arab ancestry constituted 94.3% of the sample seen whereas, subjects from Nubian ancestry (descendents from ancient tribes living in central and northern Sudan) were 5.7% of the group and no subjects from the black tribes of Southern and Western Sudan were represented. Conclusion The disease affected multiple systems as seen elsewhere. Most of the patients (96.6%) were antinuclear antibodies (ANA) positive while (51.1%) were antidouble stranded dioxyribonucleic acid (Anti-dsDNA) positive. The clinical features of SLE in our patients are comparable to what has been studied in the region. However, there was an overwhelming tendency of the disease to affect subjects of mixed ethnicity and less affection of subjects of pure African ancestry. The study is in support of the observation that SLE is rare in Black Africans living in Africa, however, it is not uncommon in subjects with Afro-Arab genetic admixture.
Evaluation of bio-insecticidal capacity of cannabis (Cannabis sativa L.) plants using GC-MS and phytochemical techniques
(2022-03-25) Zahir Abbass Hilmi; Mutaman Ali A; Abdelmonem Eltayeb Homida; Yasir Mohamed Abdelrahim; Abdalla Ibrahim Abdalla Mohamed
Plant-based pesticides are gaining attention as safe, effective, eco-friendly alternatives to synthetic pesticides. The aim of this study was to evaluate the bio-insecticidal capacity of Cannabis (Cannabis sativa) plants using GC-MS and phytochemical techniques and also mosquito's larvae as bioindicators. The phytochemical screening and the biological effect tests were run at Basic Sciences Laboratories, whereas GC-MS applications were run at the Central Laboratory, University of Gezira. The results showed that, Cannabis seeds contained flavonoids, alkaloids and steroids, and separated 5 spots through TLC. The GC-MS tests of Cannabis seeds detected Dronabinol (41.46%) as the main component, followed by Cannabinol (10.38%), Phytol (2.86%), Vitamin E (2.27%) and Caryophylene (2.07%). The ethanol extract of Cannabis seeds reflected LC50 of 218.1 mg/L, after 24. The more potent spot of Cannabis seeds was (3) against Anopheles larvae, but only spot (4) was more potent against Culex larvae and spot (5) against Aedes larvae. After one week of submission to Cannabis seed ethanol extract, the survived Anopheles larvae was 6.7%, while no survived Culex larvae, whereas 13.3% of Aedes larvae survived. Field assessment should be run to evaluate the sustainability of this products.

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