Sero-prevalence of dengue infections in the Kassala state in the eastern part of the Sudan in 2011

Dengue fever is a vector-borne disease that is transmitted to humans by infected Aedes aegypti mosquitoes. The eastern part of the Sudan is one of the regions that is affected by dengue virus circulation. In this study, we estimated the prevalence of dengue infections in the Kassala state in the eastern part of the Sudan. The study objective was to estimate the sero-prevalence of dengue IgG/IgM antibodies in the Kassala locality in 2011. This was a cross sectional community-based study that utilized a multi-stage cluster sampling technique regarding the probability sampling the study participants. Capture ELISA serological techniques were used for both IgM and IgG, with the specific cut-offs for each set by the manufacturer. The prevalence of dengue infection was found to be 9.4% [95% CI: 7.1-12.3]. In conclusion, there is evidence that the dengue virus is being transmitted in Kassala. Disease surveillance, including the clinical, serological and entomological components, should be strengthened, and additional epidemiological studies are needed to better understand of the disease burden and effects in the area

Preliminary phytochemical evaluation and seed proximate analysis of Surib [sesbanialeptocarpa DC.]

Surib [Sessbanialeptocarpa] of the family Leguminosae is a wild plant widely spread in Gezira scheme and sometimes its seeds unavoidably get mixed with machinery-harvested crops especially wheat. Different parts of Surib have been used traditionally for various illnesses in Africa where the plant spread widely. To evaluate the nutritional value of Surib. The preliminary phytochemical screening was performed using the conventional chemical tests using precipitation and color reagents as appropriate, while the standard methods of the Association of Official Analytical Chemists, 1980 were used for the determination of the proximate seed composition. Preliminary phytochemical screening of different plant parts [seeds, leaves and roots] extracts showed the presence of alkaloids in seeds and roots. Seeds and leaves of the plants were found to contain saponins, flavanoids, anthraquinones and tannins while the roots are devoid of these constituents. Proximate analysis of the seed revealed that carbohydrates and crude fibers constitute about 80% while proteins and fats values were 5.25 and 6.13% respectively. The nutrient value of Surib seed is negligible for its low content of proteins and fatty substances and thus it is of no use as animal or human food. The qualitatively determined antinutrient phytoconstituents as tannins, alkaloids, saponins and flavanoids in the seed could be considered as another main limitation to effective utilization of Surib as an animal feed and/or human food.

Seroprevalence of rubella among pregnant women in Khartoum state, Sudan

Rubella vaccine is not included in the Sudanese national immunization programme, and data on the prevalence of rubella among women of childbearing age are inadequate. The objective of this cross-sectional study was to determine the seroprevalence of rubella among pregnant women in Khartoum state, Sudan. A total of 500 pregnant women who visited 7 antenatal clinics from November 2008 to March 2009 were examined for the presence of rubella IgG antibodies using ELISA. Rubella IgG antibodies were detected in 95.1% [95% CI: 93.2%–97.0%] of women. This seroprevalence was significantly associated with education level, but not with age, residence area, occupation or parity. We presume this high seroprevalence indicates a high circulation of wild rubella virus in Khartoum state. Similar studies in other Sudanese states would be important for informing a decision to introduce rubella vaccine to Sudan.

Evaluation of Punica granatum peel against diabetic wound infection

Foot infections are a common and serious problem in diabetic patients. To investigate the antibacterial activity of some medicinal plants used by traditional healers for diabetic wounds and to examine in-vivo wound healing activity of active extracts. An experimental study in which fifteen plant extracts subjected to preliminary antibacterial screening against six standard organisms [Bacillus subtilis, Escherichia coli, Klebsiella pneumoniae, Proteus vulgaris, Pseudomonas aeruginosa and Staphylococcus aureus] using cup-plate agar diffusion method and the result was compared with activity of commonly used antibiotics. The minimum inhibitory concentration [MIC] was determined for active extracts using agar plate dilution method. The two extracts was screened against 180 clinical isolates obtained from diabetic wound infection. In this study the wound healing effect of methanolic extracts of Punicagranatum peels was tested on open skin wound model on Swiss Wistar Albino rats. Fourteen extracts [93.3%] exhibited inhibitory activity against one or more of the six organisms. The MICs of the methanolic and aqueous extracts of Punica granatum were very low against all organisms. 180 clinical isolates were obtained from diabetic wound infection, the results of identification showed that 30 were Escherichia coli, 15 Klebsiella pneumoniae, 45 Proteus spp, 15 Pseudomonas aeruginosa, 60 Staphylococcus aureus and 15 Staphylococcus epidermidis. The methanolic extract of Punica granatum peels had inhibitory effect against 99.4% of the isolates at concentration l00mg/ml. The aqueous extract has inhibitory effect against 91.7% of the isolates. Results were obtained by measuring the wound healing percentage. In the first group, healing was completed in 15 days. In the second group and third group, 13 days were required for the completion of healing. The results of this study indicated that the methanolic extract of Punica granatum had high antibacterial activity and have wound healing activity

Cytokines, lipid peroxide and nitric oxide in Egyptian hepatocellular carcinoma on top of HCV and HBV infection

Many studies have shown the relative roles of hepatitis B and C viruses in hepato-carcinogenesis. The aim of this study is to define the independent and interactive roles of some cytokines namely, TNF alpha , IL-6, IL-1 beta together with NO and TEARS in the genesis of HCC following the infection with such viruses. Blood samples were taken from 58 patients with hepatocellular carcinoma and were divided into four groups: a] 28 patients with HCV, b] 10 patients with HBV, c] 11 patients with B+C, d] 9 patients without viral infection. In addition, 20 healthy subjects served as control group for each, TNF alpha , IL-6, and IL-1 beta were measured using ELISA technique, in addition to NO and TBARs using chemical methods. Patients with coinfection B-C viral infection showed the highest levels in studied parameters. Patients with HCV and HBV separately showed more or less similar results. However, patients without viral infection showed the least higher levels comparing to the control group. Cytokines in addition to NO and TEARS have a definite role in hepatic carcinogenesis. Coinfection with the two viruses carries a synergistic risk factor of hepatocellular carcinoma development. Depending on the results of the studied parameters HCV did not show predominancy on HBV. Further studies are needed to clarify the exact mechanism of carcinogenesis especially in HCV patients

Evaluation of efficacy and side effects of different doses of intrathecal morphine for postoperative analgesia after anorectal surgery

Intrathecal opioids are frequently used in the management of postoperative pain, but may be associated with many adverse effects such as pruritus, nausea, vomiting, urinary retention, and respiratory depression, which may limit their use. Aim of this study was to compare between six different doses of IT morphine [0.1 mg, 0.2 mg, 0.3 mg, 0.4 mg, 0.5 mg and 1 mg] as regarding postoperative analgesia and the side effects of IT morphine, and to determine the optimal dose of IT morphine that provides satisfactory analgesia to the patient with minimal side effects. This study was conducted in Anesthesiology Department, Assiut university hospital, after approval of the local ethics committee. Our study was performed on 95 patients of ASA physical status I and II aged from 20 to 40 scheduled for anorectal surgeries. Spinal anesthesia was performed, with the patient in the sitting position, at L4, 5. Each patient received 5 mg of hyperbaric bupivacaine with different doses of IT morphine in a total volume of 2 ml. Patients were kept in the sitting position for five minutes to get sacral block. Intraoperative monitoring: Heart rate, O2 saturation, and non-invasive blood pressure were monitored. Postoperative monitoring: Patients were evaluated for any pain or side effect of IT morphine [Pruritus, PONV, urinary retention, and respiratory depression] during the first 24 hours. Supplemental analgesia in the form of I. V. tenoxicam was available on patient request, and the doses needed for each patient were recorded. Antipruritic and antiemetic therapy was available on patient request. Increasing the dose of IT morphine decreases the incidence of pain during the first 24 hours and subsequently decreases the need for supplemental analgesia. The doses of 0.1 mg and 0.2 mg are comparable with each other as regard to pain relief. 100% of the patients receiving 0.1 mg and 75% of the patients receiving 0.2 mg of IT morphine experienced pain during the first 24 hours and subsequently required supplemental analgesia and even with 40 mg of I. V. tenoxicam, some patient complained of postoperative pain. The doses of 0.3 mg, 0.4 mg or 0.5 mg are comparable with each other. Theses doses are enough to provide 24-hours analgesia in more than 50% of patients. This percentage increases to 100% with the use of 20-40 mg of tenoxicam intravenously. The dose of 1 mg provides 24-hours analgesia in 87% of patients. Increasing the dose of IT morphine causes significant increase in the incidence and severity of pruritus. Postoperative nausea and vomiting occurred in 30% of the patients in the control group. There is a non-significant increase in both the incidence and severity of PONV by increasing the dose of IT morphine. Urinary retention occurred in 20% of the patients in the control group. Increasing the dose of IT morphine causes significant increase in the incidence of urinary retention. Respiratory depression was not detected in any patient. Our study clearly demonstrated that the use of IT morphine in a dose of 0.3 mg in adjuvant with intravenous tenoxicam in a dose of 20-40 mg provides excellent pain relief for 24 hours after anorectal surgeries with minimal side effects of IT morphine

Aspergillus fumigatus and Cylindrocarpon candidum fungi induced apoptosis in HepG 2 cell line through activation of caspases enzymes

Many investigations are now interested to discover naturally occurring compounds, which can be used for the prevention and treatment of cancer. Most natural products which may be used as adjuvant therapy or to reduce the side effect of chemotherapy and radiotherapy. More than 300 products obtained from microorganisms have antitumor activities. In the study we isolated N-[3-4-Dichlorophenyl] 2-Methyl, 2,3 Dihydroxypropio amide from Aspergillus fumigatus and 2.4.6. Triphenyl pyridine from Cylindrocarpon candidum and investigate the cytotoxic effect and apoptotic effect on HepG2 cell line. The results revealed high cytotoxic effect at the concentration of 400 micro g/ml for both N-[3-4-Dichlorophenyl] 2-Methyl, 2,3Dihydroxypropio amide and 2.4.6. Triphenyl pyridine and effect is increase with time of incubation. The apoptotic effect of both products were investigated by measurement the caspase enzymes, the results showed highest activity of caspase 3 and caspase 9. Also at concentration 400 micro g/ml in both products. From this data we observe that two isolated product have antitumor effect and this effect is related to the concentration of the products and incubation period. Also, the two products induce apoptosis through increase activation of caspase 3 and caspase 9 which lead to programmed of cell death. This study need to furthermore study on experimental animal to confirm our results

Microbiological studies on beta-lactamase activity in staphylococcus aureus

The study of susceptibility of 92 Gram - positive bacteria to some antibiotics revealed that 27.2%, 96.0%, 13%, 100%, 7.6%, 31.5% and 17.4% of the total 92 isolates were resistant to methicillin, penicillin, tetracycillin, amoxicillin, chloramphenicol, cephradin and streptomycin respectively and only six isolates had high level of MIC ranging from 1500 to 7000 micro g/ml amoxicillin and had ability to produce beta -lactamase activity but they differ in their activities. Therefore cultural, morphological and physiological characteristic of these isolates were studied and these results indicated that they belong to Staphylococcus aureus. One isolate showed the highest level of resistance [MIC] and this isolate produced highest beta -lactamase activity. beta -lactamase activity can be affected by subminimal inhibitory concentration of some antibiotics, the maximal inhibitory effect was induced by concentration ranging from 1/2 to 1/32 of the minimal inhibitory concentration of streptomycin, clindamycin and chloramphenicol

Pattern of primary nocturnal enuresis in primary school children [first grade] in Assiut city

Objectives: To assess the prevalence of nocturnal enuresis in primary school children, first grade [6-7 years old] in Assiut. City and study its pattern and risk factors

Patients and Methods: A random cross-sectional study including 1519 children was conducted in 10 primary schools in Assiut City throughout a period of six months. A self-administered questionnaire was completed voluntarily by the parents. Children reporting two or more incidents of nocturnal enuresis per month during the preceding year were considered positive repliers and were subjected to further evaluation. The control group consisting of 100 age-matched non-enuretic children presenting for other urologic or non-urologic problems mandating a plain abdominal X-ray, was subjected to the same evaluation. In these children the possible detection of spina bifida was the point of concern

Results: The response rate to the questionnaire was 79%. The prevalence of enuresis was 20.2%. Out of the enuretic children, 87.6% complained of nocturnal enuresis only; 72.1 % of them were primary enuretics. Monosymptomatic enuresis was observed in 46.3% of the cases. Marked enuresis [every night] affected 52% of the total number of enuretic children. Statistically significant risk factors were deep sleep and a high educational level of the parents. Primary nocturnal enuresis was insignificantly associated with a positive family history, family size or birth rank. In primary nocturnal enuretics the results of the urogenital and neurological examinations were normal in 91.5% and 80.6%, respectively, and only 4% received a specific treatment. A large amount of post-void residual urine was observed in 7.4%. Spina bifida occulta was observed in 10.8% of primary nocturnal enuretics and in 11 % of the control group

Conclusions: This is the first large population based study of the prevalence of agerelated enuresis in Assiut, but it does not differ much from those reported in other parts of the world. Enuretic children and their parents are mildly concerned about enuresis. Investigations for mono-symptomatic primary nocturnal enuresis are not of significant diagnostic value or cost effectiveness

Factors affecting variations in exposure to infections by Leishmania donovani in eastern Sudan

A cross-sectional survey was carried out in Gedaref state, eastern Sudan to investigate the prevalence of positive leishmanin skin tests and environmental factors related to Leishmania donovani infection. A total of 3835 people living in 11 villages in 3 regions were screened. Soil types and tree densities were determined in 33 villages inhabited by 44 different tribes. The highest rates of positive skin tests were in Rahad region [33.9%], Atbara [21.6%] and Gedaref [10.6%], with an average of 21.1% for the state. Risk of infection by L. donovani varied significantly between different tribes. Higher densities of Acacia and Balanites spp. trees were in Masaleet villages, suggesting that the relatively high risk of L. donovani exposure in this tribe is due to environmental factors

Incidence of pseudomonas aeruginosa nosocomial catheter-associated urinary tract infection in Assiut University Hospital

To perform an incidence and typing study of P. aeruginosa catheter associated urinary tract infection [CAUTI] in two departments of Assuit University Hospital; the department of Urology and the Intensive Care Unit [ICU]. This study was done along the period of about 4 months. It involved 150 hospitalized patients in Assiut University Hospital; half of them from the department of Urology, and the other half were from the intensive care unit [ICU]. They were divided into two groups; cases and control. The case group included 100 patients having urinary catheters for more than 3 days, with age between 10 and 63 years old. Of the case group 65 were male patients and 35 were female patients. The control group included 50 age and sex matched hospitalized non-catheterized patients; half of them were from the department of Urology, and the other half from the ICU. Urine sample were collected from both the case and control groups and examined for bacteriuria and pyuria. Then examined bacteriologically [cultural characteristics and biochemical reactions] for isolation of P. aeruginosa. The isolates were typed by pyocine typing. Catheter-associated urinary tract infection [CAUTI] represents a great proportion of nosocomial UTI. The incidence in the department of urology was significantly higher than that in the ICU. Old age, female sex, diabetes, catheterization for more than 6 days, all favors the occurrence of CAUTI. The pre-use of second, third generation cephalosporins or quinolones decreased the incidence of CAUTI while the pre-use of ampicillin and gentamicin elevated that incidence. Most of the diagnosed CAUTI cases were caused by gram negative bacilli, which were mostly single infection. Incidence of P. aeruginosa UTI was significantly higher in cases than in controls. That incidence was equal in the two studied departments. There is a high incidence of CAUTI in Assiut University Hospital. And a high level of P. aeruginosa infection. So we recommend the use of the different preventive measures

New approach for management of impotence

A new type of topically applied drug [Eroderm-3 cream] for impotence was presented. Eroderm-3 cream contains vasoactive drug that had the ability to penetrate the penile cutaneous issue and facilitate erection. In this study, the usefulness of Eroderm-3 was examined in the treatment of erectile dysfunction. Eroderm-3 contains co- dergocrine mesilate, aminophylline and isosorbide dinitrate. A randomized double-blind controlled trial on 36 patients was performed after the etiology of impotence was investigated. All patients received Eroderm-3 and placebo cream. The patients were randomly divided into two groups each of eighteen patients. The first group received Eroderm-3 in the first month and placebo cream in the second month, while the second group received placebo in the first month and Eroderm-3 in the second month. The patients were advised to apply the cream on the penile shaft quarter of an hour before sexual stimulation and intercourse. The patients reported their experience via questionnaire. Twenty-one patients reported full erection and satisfactory intercourse, two patients reported partial erection and four patients reported just tumescence. Three patients reported full erection and satisfactory intercourse with either cream, while neither Eroderm-3 nor placebo cream produced a noticeable response in nine patients. The highest activity proved to occur in psychogenic impotence, while less rate of success was observed in patients with venous leakage. Laboratory testing of Eroderm-3 showed a high activity in increasing penile arterial flow and induced tumescence in 61% of patients. No marked side effects were recorded

Evaluation of impotent male

This study was performed to asses further the efficacy of the diagnostic modalities in evaluation of men presented with erectile dysfunction. Two hundred and ten impotent males were evaluated. After thorough history taking, clinical examination and basic laboratory investigation; no organic etiology could be elected in 93 patients and they were considered to have psychogenic causes. All the organic group patients [117] were subjected to color duplex study for the cavernosal arteries. Cavernosometry and cavernosography were done for those with suspected venous leakage which was recognized in 60 patients. Prolactin level was done for those with low testosterone level. Forty patients had arteriogenic impotence, thirteen patients had mixed etiologic factors, only three patients had neurogenic etiology and one patient had pure hormonal etiology

TB epididymitis is not uncommon incident

100 cases of epididymitis were randomly chosen provided that they didn't receive antibiotics in the last 48 hours. We categorized the patients into two groups: those presenting with acute painfull scrotal swelling and fever into group A [5 6 patient] and those presenting with painless scrotal lumb of more than 3 months duration into group B [44 patients]. - Full clinical assessment including careful history taking and clinical examination was done to all patients. - Urine smears stained with Z.N. -staining were examined for alcohol and acid fast bacilli for all patients, and similar semen smears for group [B] patients were also done. - Urine culturing on Lowenstein-Jensen medium was done for all patients. - Semenogram was done for group [B] patients. - Semen of group [B] patients was cultured also on Lewenstein-Jensen medium. Abdominal ultrasound together with chest x-ray and plain x-ray abdomen had been performed to all cases. In Group [B] patients, I V.U was routinely done. It is clear that chronic epedidymitis is highly suspecious for T.B. It had been found that semen culturing or smearing by Z-N-Stain gave a better chance-than urine to isolate the T-B bacillus [semen smearing and culturing proved that 15.9% and 29% of patients respectively were positive for T.B. bacilli compared to 13.6% and 25% of patients in case of urine]. Semen parameters had been variably affected in tuberculous involvement of the epididymitis specially in bilateral cases [all bilateral cases and 3 out of 8 unilateral involvement were infertile]. In conclusion, T.B. bacillus is a relatively common causative organism in cases of chronic epididymitis [13% of total cases of epididymitis and 29% of chronic cases]

Substitution urethroplasty using a venous graft: experimental trial in donkeys

Substitution urethroplasty was performed in 9 donkeys. In each donkey a urethral segment was removed and a venous graft from the jugular or saphenous vein was exposed and harvested by ligation of both ends of the vein. In three animals [group I], a suitable sized multifenstrated Ryle tube was introduced to bypass the urethra and the venous graft to drain the urinary bladder. The cut ends of the urethra and those of the graft were approximated and spatulated anastomosis was performed on the tube. In six donkeys [group II] a perineal urethrotomy was done and Foley's catheter was introduced through it to drain the bladder, and the anastomosis was separately stented. In all animals continuous locked 4/0 catgut sutures were used. The animals were observed for 3 mouths and the outcome and complications were recorded. After follow up for 3 months, one animal had a fistula, 2 animals had urethral stricture and the rest of the animals [6 donkeys] had smooth patent pathway. The results indicated that venous graft is a worthy trial for substitution of urethral defects of variable lengths [2-5 cm long]. The anastomosis should be spatulated and stented with proximal urinary diversion

Endourologic management of virtually impassable urethral stricture

Fifty patients with hardly passable or impassable [obliterated] urethral stricture were endourologically managed to get a patent urethra. These strictures, were either post inflammatory [38 cases] or post-traumatic in [12 cases]. A guide wire was introduced [through passable strictures] in retrograde or antegrade directions. Then, visual urethrotomy or guided dilatation by graduated teflon dilators [up to 20 F] followed by blind urethrotomy was performed. Light guide or a curved sound tip were aligned [under fluoroscopy] with the urethrotome peak on both ends of the stricture to guide cutting in cases of complete urethral obliteration. Follow up of those patients for 18 months revealed good results in term of unobstructed flow with no residual urine [in 40 patients]. Revision urethrotomy was necessary in 8 patients and open urethroplasty was performed for 2 patients

Biochemical effects of some natural chelating agents decreasing lead toxicity

Lead was determined in River Nile water and tap water in different localities of Great Cairo. The results revealed a high degree of lead pollution. In an attempt to reduce the biochemical effect of lead poisoning, 2% pectin or 2% chitin were incorporated in the rat diet given 200 ppm pb [as lead acetate] in drinking water. Four groups of rats were used [each group 10 rats] and the experiment was conducted for 42 days. Regarding lead content in different organs and blood, a net decrease occurred by pectin or chitin addition to the diet. In case of pectin addition, lead content in liver, kidney, brain and blood decreased by 38.3, 46.4, 24.05 and 12.1% respectively as compared with rat given 200 ppm Pb in drinking wafer. In case of chitin addition a similar trend was observed. Glutathion content significantly decreased in liver, kidney and blood by pectin or chitin addition. Got, GPT, alkaline phosphatase activities, haemoglobin and hematocrite values were close to those of controls. Statistical analysis was also carried out on the above results

Biochemical studies on the effect of lead pollution

The level of lead deposition and the extent of vegetables pollution were studied. Lead in unwashed Ficus nitida leaves throughout the four seasons in Great Cairo averaged 45 ppm in Giza and 3.6 ppm in low polluted area. Washed leaves showed values ranging from 0.88 to 19.9 ppm. Vegetables collected from 20 markets in Cairo indicated that Spearmint. Leaves had the highest lead content [92.Oppm] followed by Lettuce [22 ppm] and tomatoes [2.7 ppm]. An experiment was carried out to study the biological effect of lead in drinking water. Lead was given to rats in drinking water containing 0.0, 100, 2140, and 1000 ppm. as lead acetate for 42 days. Lead content increase in kidneys, brain, blood and liver by 23.7, 18.15, 11.3 and 8.7 -folds by giving 1000 ppm, as compared with specific control. Glutathione in different organs and blood showed also a positive correlation with lead ingestion. Hemoglobin and Hematocrit decreased by about 50% in blood by increasing lead up to 1000 ug/ml in drinking water. GPT. GOT and alkaline phosphatase activities were significantly increased by increasing lead doses drinking water

Bile acid and cholinesterase activity as an early liver function tests for detection of organic solvent hepatotoxicity

Forty-six workers exposed to different types of organic solvents and fourteen workers far from exposure were included in this study. The exposed workers were classified into 3 groups according to the nature of the work and the type of solvent; group A [acetone, n-hexane-exposed workers], group B [toluene, xylene-exposed workers] and group C [trichloroethylene, isopropyl alcohol, methyl alcohol exposed workers]. Routine liver function tests appear normal. Serum bile acid and serum cholinesteracse were estimated in all workers. The results showed a significant increase in serum bile acid in all exposed groups compared with the non-exposed group. Serum cholinesterase activity was significantly lower in the exposed groups than the non-exposed group. From these results we can conclude that, serum bile acid and serum cholinesterase represent an early and sensitive tests for detection of organic solvent hepatotoxicity

Thermal requirements for development of Earias insulana boisd [Egyptian strain]

Earias insulana shows optimal preimaginal development and survival at temperatures between 25?C and 27°C. Its development, from oviposition to adult emergence, requires an effective temperature sums [k] of 329.9 heat degree days above the theoretical threshold for development [t%] of 14.3°C. The [t%] values for all stages vary between 13.2°C. and 15.9°C. The lowest [t%] value is observed for the egg stage. The [t%] values are varying between 15.5-123 heat degree days above the theoretical threshold for their development. Based on thermal characteristics, this species may produce six to eight generations per year allover Delta region. The number of generations, calculated by the effective temperature sums [k], has been approved by the periodical system of development and reproduction which is designed for this species. The t o/n value, calculated for different regions in Delta, varied between 19.9°C. and 21.3°C. The value of [t o/1] which is the actual temperature for development is also calculated