Molecular typing of Mycobacterium spp. isolates from Yemeni tuberculosis patients

This study was done to characterize at the species level Mycobacterium spp. isolates from Yemeni pulmonary tuberculosis patients. Early-morning sputum samples were collected from 170 patients referred to the National Tuberculosis Institute in Sana'a city with suspected pulmonary tuberculosis. Samples were processed with Ziehl-Neelsen stain and cultured in Ogawa and Lowenstein-Jensen media. The rpoB gene target sequence was amplified using mutagenesis forward and reverse primers followed by Hindlll enzyme digestion. Of the 120 isolates analysed, 118 [98.3%] were identified as M. tuberculosis complex and 2 [1.7%] were identified as mycobacteria other than M. tuberculosis. The results showed that those 2 isolates were multi-drug resistant and the DMA sequencing analysis showed that the alignment of nucleic acid of DNAin isolates of mycobacteria other than M. tuberculosis was different from that of M tuberculosis complex

unusual case of mucosal leishmaniasis with cutaneous dissemination in Sudan and its epidemiological significance

Sudan is endemic for visceral, cutaneous and mucosal leishmaniasis. The latter is the least common of the three forms of leishmaniasis. It is caused by L. donovani, the same parasite that causes visceral leishmaniasis [VL] in the country. Most of the cases were reported from VL endemic areas, the majority in adults. The disease may be primary in the oral and or the upper respiratory mucosa or may follow or accompany visceral leishmaniasis. This paper is a report of a case of mucosal leishmaniasis of the nose and lips. It is unusual in several aspects: the disease was acquired in a village where no cases of VL or mucosal leishmaniasis were recorded within living memory, before an outbreak in 1981 during which the patient was infected; the patient was infected at the age of five years and the disease remained active for 22 years causing physical deformity and psychological trauma to the patient

Antimony-resistant Leishmania donovani in eastern Sudan: incidence and in vitro correlation

A longitudinal study was done in a leishmaniasis -endemic region in eastern Sudan during the period November 2001-February 2003 to determine the incidence of failure of sodium stibogluconate treatment. We studied 820 confirmed visceral leishmaniasis patients. All were treated with sodium stibogluconate, 20 mg/kg body weight for at least 28 days. Parasites were isolated from lymph node aspirates from 22 participants identified as relapsed patients. All isolates were typed as Leishmania donovani based on polymerase chain reaction [PCR] amplification of parasite kDNA. Six parasites showed in vitro resistance to sodium stibogluconate using murine J774 macrophage amastigote testing method. The resistant isolates showed different restriction profiles when the amplified kDNA PCR products were digested with ALU1 restriction enzyme, indicating that resistance was mediated by different parasite clones

Effects of single-dose praziquantel on morbidity and mortality resulting from intestinal schistosomiasis

The long-term effect of single-dose praziquantel on morbidity and mortality from Schistosoma mansoni was investigated in surveys in 1987 and 1994 in central Sudan. Prevalence of infection dropped from 53% to 34%, and intensity of infection [400 eggs/g of faeces] from 31% to 18%. There was a reduction in hepatomegaly and hepatosplenomegaly, although splenomegaly alone was unchanged. Prevalence of periportal fibrosis decreased from 14% to 10%. Endoscopic investigation of patients with fibrosis showed a reduction in oesophageal varices from 47% to 30%. Mortality due to bleeding varices was high [community-wide, up to 11/100 infected patients with bleeding]. Thus praziquantel mass treatment can be spaced to a much longer period, reducing the expense of treatment, delivery and distribution

Down's syndrome with coexistent gout in 2 patients: Is the association under reported or is the prevalence actually increasing?

This report describes 2 patients diagnosed with Down's syndrome and who developed acute gouty arthritis. While hyperuricemia in gout is a well-known abnormality, association of gout with Down's syndrome has not been widely discussed. With increasing life expectancy in this syndrome, it is likely that more such cases will occur. For early diagnosis and proper management clinicians must be aware of this association

Comparative study between open cholecysectomy and laparoscopic cholecystectomy

In this study, the results of 350 patients underwent laparoscopic cholecystectomy [LC], were compared with those of 420 patients on whom open cholecystectomy [OC] was performed, in Banha University Hospital. Laparoscopic cholecystectomy patients included cases presented as symptomatic chronic calcular cholecystitis [96.3%] and acute cholecystitis [3.7%], while OC patients included cases with both chronic [74%] and acute cholecystitis [18.6%] and common bile duct stones [7.4%]. The mean operative time was significantly longer in LC. This procedure was completed in 325 out of 350 patients, while converted to open in 25 patients [7.1%], with fewer complications in 20 patients [5.7%]. The mean postoperative stay was significantly shorter in LC. No mortality was reported in both groups, while the complication rate was 5.7% in LC and 9% in OC