Impact of COVID-19 on blood donation and supply in Africa

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Serum Periostin Level in Asthmatic Children with Exercise Induced Bronchospasm

Background:There are few biomarkers that can be easily accessed in clinical settings and may reflect refractory Th2-eosinophlic inflammation and remodeling of the asthmatic airways. Serum periostin may be one such biomarker to aid our understanding of the patho-bio-physiology of asthma and exercise induced asthma. The aim of the study is to explore the relationship between serum periostin level and exercise induced bronchoconstriction in asthmatic children.Materials and Methods: This cross-sectional study was carried out on (90) children both sexes aged from 6 to 15 years including, (60) children with bronchial asthma and (30) children were enrolled as control group in the period from January 2018 to January 2019. Patients were randomly classified into two groups: I) Patient group: divided into 2 groups according to standardized treadmill exercise challenge test: Group A: (30) asthmatic children with positive test. Group B: (30) asthmatic children with negative test. II-Control group: (30) children apparently healthy with no personal or family history of asthma. All children were subjected to the following Investigations: Chest x-ray, pulmonary functions tests (FEV1& PEFR) except controls, Laboratory investigations as CBC and Serum periostin level Results:The mean values of both the percentage of PEFR and FEV1 after exercise in group A were significantly lower than those in group B and the percentage of PEFR and FEV1after exercise in each group were significantly lower than the percentage before exercise in the same group. The mean value of eosinophilic count in group A was significantly higher than (group B and control group) and the mean value of eosinophilic countin group B was significantly higher than control group. The mean value of serum level of periostin in group A was significantly higher than (group B and control group), however, there was no significant difference between group B and control group as regard to serum level of periostin.Chest tightness, cough and wheezes after exercise and eosinophilic count in patients with high serum periostin level were significantly higher than patients with low serum periostin level, and both PEFR and FEV1after exercise in patients with high serum periostin level were significantly lower than patients with low serum periostin level. Also the normal serum periostin levels vary among different age groups.Conclusion:Serum periostin level can be considered as a useful biomarker for diagnosis of Exercise induced bronchospasm (EIB) in asthmatic children especially when lung function test cannot be done However, cautious is required in evaluating serum periostin levels in children because it varies with age.

Evaluation the role of laparoscopic management of complicated appendicitis

Background: A laparoscopic appendectomy (LA) was performed mostly on uncomplicated appendicitis due to opinions about its safety when it was first introduced. Nevertheless, there are still concerns about surgical difficulties in managing complicated appendicitis with laparoscopy, possible post-op complications and conversion to an open appendectomy (OA) during the surgery.Methods: The study consists of 30 patients who underwent laparoscopic appendectomy in department of General Surgery at Assiut University hospitals. The study population was enrolled after fulfilling the selection criteria from department of General Surgery. Informed consent was taken from all the patients who are involved in this study. Patients diagnosis was based on clinical findings, complete blood counts, and abdominal sonography.Results: Thirty patients underwent laparoscopic appendectomy for complicated appendicitis. Of the 30 patients, perforated appendix cases are 27, gangrenous appendix are 1, appendicular abscess only one case. Post operation wound infection, conversion rate and hospital stay rate very less.Conclusions: The present study proved that laparoscopic appendectomy is the best approach in complicated appendicitis.

Moringa oleifera leaf ethanol extract ameliorates lead-induced hepato-nephrotoxicity in rabbits

Objective: To evaluate the effect of Moringa oleifera leaf ethanol extract as an adjunct treatment on lead acetate induced hepato-nephrotoxicity in rabbits.Methods: Thirty-six male New Zealand White rabbits were assigned into two main groups. The first group (14 rabbits) served as normal control. The second group (22 rabbits) was administered orally with lead acetate at a dose of 40 mg/kg/day, 5 days/week for 8 weeks. At the 4th and the 8th week of treatment, 6 animals (3 animals at each period) of the second group were sacrificed while the remaining animals (16 rabbits) were assigned randomly into 2 subgroups (8 rabbits each): treated and non-treated. The first subgroup was orally given 1 mL phosphate-buffered saline for further 4 weeks while the second subgroup was administered orally with Moringa oleifera leaf ethanol extract at a dose of 400 mg/kg/day for the same period. Blood samples were collected to determine hematological and serum biochemical indices. Tissue specimens were collected from the liver and kidney for evaluation of the oxidant/antioxidant markers and for histopathological examinations. Results: Lead acetate exposure decreased the mean body weight gain, hematocrit, hemoglobin, mean corpuscular volume, and lymphocytes count. Moreover, it markedly increased counts of monocytes and platelets, serum enzyme activity, levels of creatinine, total cholesterol, triglycerides, and low-density lipoprotein cholesterol. Malondialdehyde level was markedly increased while the reduced glutathione content was significantly decreased in liver tissue of lead intoxicated-rabbits. Histopathological alterations were also noticed in the liver and kidney of lead intoxicated rabbits. Moringa oleifera leaf ethanol extract significantly improved hematological and serum biochemical parameters and histopathological structure of the liver and kidney. Conclusions: Moringa oleifera leaf ethanol extract ameliorates hemato-biochemical and histopathological alterations caused by lead acetate and improves hepatic and renal functions.

Comparative analysis of camelid mitochondrial genomes

Camelus dromedarius has played a pivotal role in both culture and way of life in the Arabian peninsula, particularly in arid regions where other domestic animals cannot be easily domesticated. Although, the mitochondrial genomes have recently been sequenced for several camelid species, wider phylogenetic studies are yet to be performed. The features of conserved gene elements, rapid evolutionary rate, and rare recombination make the mitochondrial genome a useful molecular marker for phylogenetic studies of closely related species. Here we carried out a comparative analysis of previously sequenced mitochondrial genomes of camelids with an emphasis on C. dromedarius, revealing a number of noticeable findings. First, the arrangement of mitochondrial genes in C. dromedarius is similar to those of the other camelids. Second, multiple sequence alignment of intergenic regions shows up to 90% similarity across different kinds of camels, with dromedary camels to reach 99%. Third, we successfully identified the three domains (termination-associated sequence, conserved domain and conserved sequence block) of the control region structure. The phylogenetic tree analysis showed that C. dromedarius mitogenomes were significantly clustered in the same clade with Lama pacos mitogenome. These findings will enhance our understanding of the nucleotide composition and molecular evolution of the mitogenomes of the genus Camelus, and provide more data for comparative mitogenomics in the family Camelidae.

Punica granatum suppresses colon cancer through downregulation of Wnt/β-Catenin in rat model

Abstract This study aims to elucidate the beneficial effect of Punica granatum L., Lythraceae (pomegranate) peel extract in the management of colon cancer induced intrarectally with N-methylnitrosourea. Adult male Sprague-Dawley rats were administered N-methylnitrosourea (2 mg in 0.5 ml water/rat) intrarectally three times/week for five weeks to induce colorectal cancer, followed by treatment with either 5-fluorouracil (12.5 mg/kg, i.p.) or Punica peel extract (2.25 or 4.5 g/kg, p.o.). Developed tumor elevated plasma TGF-β, and Bcl2, serum epidermal growth factor, carcinoembryonic antigen, colon cancer specific antigens, and matrix metalloproteinase-7. Besides, immune-histochemical studies revealed an increase in COX-2, cyclin D1 and survivin content, as well as upregulation of the expression of colonic β-Catenin, K-ras and C-myc genes. These results were further supported by the histological findings. Punica peel extract-treated rats, particularly those treated with a high dose, exhibited a marked reduction in the aforementioned parameters and improved the histological organization of the colon tissue. These alterations were consistent with those mediated through 5-fluorouracil. The present study encourages the use of P. granatum L. against colon cancer. Because Punica peel extract promotes apoptosis, mitigates inflammation and suppresses tumor cell proliferation in vivo, the potential mechanism underlying these activities might depend on the inhibition of the Wnt/β-Catenin signaling pathway.

Mesua ferrea stem bark extract induces apoptosis and inhibits metastasis in human colorectal carcinoma HCT 116 cells, through modulation of multiple cell signalling pathways / 中国天然药物

Considering the great potential of natural products as anticancer agents, the present study was designed to explore the molecular mechanisms responsible for anticancer activities of Mesua ferrea stem bark extract against human colorectal carcinoma. Based on MTT assay results, bioactive sub-fraction (SF-3) was selected for further studies using HCT 116 cells. Repeated column chromatography resulted in isolation of less active α-amyrin from SF-3, which was identified and characterized by GC-MS and HPLC methods. α-amyrin and betulinic acid contents of SF-3 were measured by HPLC methods. Fluorescent assays revealed characteristic apoptotic features, including cell shrinkage, nuclear condensation, and marked decrease in mitochondrial membrane potential in SF-3 treated cells. In addition, increased levels of caspases-9 and -3/7 levels were also observed in SF-3 treated cells. SF-3 showed promising antimetastatic properties in multiple in vitro assays. Multi-pathway analysis revealed significant down-regulation of WNT, HIF-1α, and EGFR with simultaneous up-regulation of p53, Myc/Max, and TGF-β signalling pathways in SF-3 treated cells. In addition, promising growth inhibitory effects were observed in SF-3 treated HCT 116 tumour spheroids, which give a hint about in vivo antitumor efficacy of SF-3 phytoconstituents. In conclusion, these results demonstrated that anticancer effects of SF-3 towards colon cancer are through modulation of multiple molecular pathways.

Cyclophosphamide versus cyclosporine in children with frequent-relapsing and steroid-dependent nephrotic syndrome in Khartoum State, Sudan

Background: in children with frequent-relapsing and steroid-dependent (FR/SD) nephrotic syndrome (NS) remission can be achieved with either cyclophosphamide (CPM) or cyclosporine(CSA). Our objective was to compare the efficacy and safety of these agents.Methodology: Records of all children with FR/SD NS who received CPM or CSA at the Pediatric Renal Unit, Soba Hospital, Khartoum, during the period 2005­2015 were retrospectively reviewed.Main outcomes were: remission rate, relapse rate, and renal outcome.Results: We studied 82 children with FR/SD NS treated with CPM (59.8%) or CSA (40.2%). Males were 69.5% and females 30.5%. The mean admission age was 5 ± 3.10 years. At 6 months,77.6% children on CPM and 60.3% on CSA were in complete remission (CR), (P=0.012) whereas 22.4% versus 39.4% relapsed respectively (P=0.012). At 12 months, 57.5% on CPM and 72.7%on CSA were in CR, (P=0.013) whereas 42.5% versus 27.3% relapsed respectively, (P=0.013). At 24 months, 16.6% on CPM and 29% on CSA were in CR, (P=0.030) whereas 83.4% versus 71%relapsed respectively, (P=0.030). The mean number of relapses per 24 months were 1.7± 0.86 inCPM group versus 2.2 ±0.85 in CSA group, (P=0.72). Mild complications were recorded in 12.4% of patients on CPM group versus 33.3% on CSA, (P=0.031). At the latest follow- up, there was no significant change from basal levels of TWBC, mean serum creatinine, GFR, or BMI, (P>0.05 for all parameters). Conclusion: In children with FR/SD NS, both CPM and CSA were effective and safe in achieving remission with less risk of serious side- effects. However, long-term remission was less stable with both agents

Evaluation of primary repair of common bile duct in common bile duct stones

Background: Despite advancements in gallbladder surgery with the introduction of endoscopic and laparoscopic techniques, many surgeons, especially in the developing world, still perform open cholecystectomy with common bile duct [CBD] exploration for choledocholithiasis

Aim of the study: The purpose of the study was to report the outcomes of open CBD exploration without theuse of Tetubes

Materials and methods: A prospective study of open CBD exploration and primary closure was performed without Tetube drainage. Preoperative investigations, the surgical techniques, and perioperative outcomes were recorded

Results: Fifty patients had CBD exploration. In 45 patients this was performed by means of asupraduodenal choledochotomy, and in five of these patients free passage into the duodenum could not be achieved using catheters, irrigation, and dilators. These were completed with acholedochoduodenostomy

Conclusion: In a limited resource setting, there is still a role for open CBD exploration and primary closure without the necessity of Tetubes and stents as evidenced by a good perioperative patient outcome

Ethyl-p-methoxycinnamate isolated from kaempferia galanga inhibits inflammation by suppressing interleukin-1, tumor necrosis factor-α, and angiogenesis by blocking endothelial functions

OBJECTIVE: The present study aimed to investigate the mechanisms underlying the anti-inflammatory and anti-angiogenic effects of ethyl-p-methoxycinnamate isolated from Kaempferia galanga. METHODS: The anti-inflammatory effects of ethyl-p-methoxycinnamate were assessed using the cotton pellet granuloma assay in rats, whereby the levels of interleukin-1 and tumor necrosis factor-α were measured in the animals' blood. In addition, the levels of interleukin, tumor necrosis factor, and nitric oxide were measured in vitro using the human macrophage cell line (U937). The analgesic effects of ethyl-p-methoxycinnamate were assessed by the tail flick assay in rats. The anti-angiogenic effects were evaluated first by the rat aortic ring assay and, subsequently, by assessing the inhibitory effects of ethyl-p-methoxycinnamate on vascular endothelial growth factor, proliferation, migration, and tube formation in human umbilical vein endothelial cells. RESULTS: Ethyl-p-methoxycinnamate strongly inhibited granuloma tissue formation in rats. It prolonged the tail flick time in rats by more than two-fold compared with the control animals. The inhibition of interleukin and tumor necrosis factor by ethyl-p-methoxycinnamate was significant in both in vivo and in vitro models; however, only a moderate inhibition of nitric oxide was observed in macrophages. Furthermore, ethyl-p-methoxycinnamate considerably inhibited microvessel sprouting from the rat aorta. These mechanistic studies showed that ethyl-p-methoxycinnamate strongly inhibited the differentiation and migration of endothelial cells, which was further confirmed by the reduced level of vascular endothelial growth factor. CONCLUSION: Ethyl-p-methoxycinnamate exhibits significant anti-inflammatory potential by inhibiting pro-inflammatory cytokines and angiogenesis, thus inhibiting the main functions of endothelial cells. Thus, ethyl-p-methoxycinnamate could be a promising therapeutic agent ...

[Management of anorexia nervosa in a Tunisian case]

Anorexia nervosa is a complex psychiatric illness that can lead to severe physical complications. This work aimed to study the approach taken by the child psychiatry service of Razi hospital in the management of anorexia nervosa and to compare it with international recommendation. We propose to illustrate by a case report the management of anorexia nervosa in its typical form and review international recommendations on this topic while undertaking a review of the literature based on a Medline search using the following keywords: anorexia nervosa, adolescence, management, guidelines. Case report: AS, 16 years old, addressed to us by the school doctor for management of anorexia nervosa evolving for two years without improvement through outpatient care. His condition was considered precarious requiring urgent care in a medical hospital. She was then hospitalized at the Institute of Nutrition with a weight contract to achieve. She received a gradual refeeding strongly denied. We have provided a psychological support by moving on site three times a week to help establish a good therapeutic alliance. After three weeks, the teenager has reached an acceptable weight for its output to the hospital and additional support at the outpatient child psychiatry with supportive psychotherapy. Two months later, she developed depression because of the weight gain. The appointment at the dietician was continued three months after hospitalization. At 10 months of the hospitalization, the girl At 10 months of the hospitalization, the girl had good grades and was not amenorrheic. However, on the psychological level she kept the same traits and intrafamilial relationships were marked by the seal of the manipulation. Subsequently, the teenager has spaced the consultations then lost sight. Currently, at 15 months of the hospitalization, parents describe a

relapse, with a dietary restriction without amenorrhea and a refusal to take weight. [asterisk] In management of this patient, we followed the recommendations of the literature namely those of the High Authority of Health and NICE

[National Institute for Clinical Excellence] which recommend a target tracking of anorexia nervosa, the establishment of a multidisciplinary team care, a long hospitalization with a weight contract, support and cognitive therapy of the body image when the initial outpatient care is not effective. Similarly, for children and adolescents, family therapy is recommended as an outpatient after hospitalization. In our country, the prevalence of anorexia nervosa is gradually increasing although we have not an idea concerning the frequency or prevalence of this disease which has serious and unpredictable complications. For what, It requires a multidisciplinary and prolonged surveillance to prevent recurrence

Assessment of health-related quality of life among adolescents with type 1 diabetes mellitus in Saudi Arabia

To evaluate the health-related quality of life [HRQoL] for adolescents with type 1 diabetes mellitus [T1DM]. A cross-sectional study was conducted among 214 adolescents [13-18 years] with T1DM at the Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia from June to September 2013. Respondents were selected by their availability during routine visits to outpatient clinics, and interviewed using the Arabic translated version of the Pediatric Quality of Life Inventory 3.0 Diabetes Module [PedsQL 3.0 DM] independently. Female gender, multiple daily injection [MDI], longer duration of T1DM [>7 years], diabetic ketoacidosis [DKA] and adolescents with >7 HbA1c level had at least one poor HRQoL outcome. Multivariate linear regression analysis showed that age, treatment type [MDI], DKA, and >7 HbA1c were independent influencing factors for subscale diabetes symptoms, whereas >7 HbA1c was the independent influencing factor for treatment barriers and overall HRQoL. The DKA was the independent influencing factor for the subscale of worry, and female gender was the independent influencing factor for the subscale of communication. Female gender, age, treatment type, >7 HbA1c, and DKA are the strongest determinants for lower HRQoL for at least one subscale of the PedsQL 3.0 DM

Clinical pathways for non-ST elevation acute coronary syndrome in Oman: an Oman heart association protocol for hospital quality improvement initiative

In 2012, Oman Heart Association [OHA] published its own guidelines for the management of patients with unstable angina/ non-ST-elevation myocardial infarction, the aim was not to be comprehensive but rather simplified and practical in order to reduce the gap between the long comprehensive guidelines and our actual practice. However, we still feel that the busy registrars and residents need simpler and direct clinical pathways or protocol to be used in the emergency departments, coronary care units and in the wards. Clinical pathways are now one of the main tools used to manage the quality in healthcare concerning the standardization of care processes. It has been shown that their implementation reduces the variability in clinical practice and improves outcomes in acute care

Comparative study on the effect of antioxidants alpha-lipoic acid and N-acetyl cysteine on the structure of the renal tubules of diabetic rabbits

Hyperglycemia-induced oxidative stress plays a central role in the pathogenesis of diabetic complications. The therapeutic potential of antioxidants in the prevention and treatment of these complications is an emerging research area. The roles of alpha-lipoic acid [ALA] and N-acetyl cysteine [NAC] in the protection against oxidative stress in alloxan-induced diabetic rabbits were assessed both biochemically and histologically in this study. Thirty-two mature male rabbits were used in this study. They were divided into two groups: the control group [n=8] and the experimental [n=24] group; the experimental group was injected intraperitoneally with alloxan [180mg/ml/kg body weight]. After 3 weeks, this group [diabetic rabbits] was subdivided into three subgroups of eight rabbits each. The first one was left as the untreated diabetic subgroup; rabbits in the second and third subgroups were treated daily for 7 days with ALA and NAC [100 mg/ml/kg body weight], respectively. At the end of the experiment, blood and kidney sections were processed for biochemical and histological studies. The renal tubules showed degenerative and apoptotic changes, which were associated with increased DNA fragmentation and lipid peroxidation in the kidney tissues, as well as reduction in the capacity of the antioxidant defense system. However, treatment of diabetic rabbits with either ALA or NAC ameliorated diabetes-induced oxidative stress. ALA and NAC could be useful in the prevention and treatment of oxidative stress associated with hyperglycemia. This action seems to result mainly from direct scavenging of reactive oxygen species and restoring of the GSH [glutathione] redox state

Genotoxicity and acute and subchronic toxicity studies of a standardized methanolic extract of Ficus deltoidea leaves

OBJECTIVE: Ficus deltoidea leaves have been used in traditional medicine in Southeast Asia to treat diabetes, inflammation, diarrhea, and infections. The present study was conducted to assess the genotoxicity and acute and subchronic toxicity of a standardized methanol extract of F. deltoidea leaves. METHODS: Sprague Dawley rats were orally treated with five different single doses of the extract and screened for signs of toxicity for two weeks after administration. In the subchronic study, three different doses of the extract were administered for 28 days. Mortality, clinical signs, body weight changes, hematological and biochemical parameters, gross findings, organ weights, and histological parameters were monitored during the study. Genotoxicity was assessed using the Ames test with the TA98 and TA100 Salmonella typhimurium strains. Phytochemical standardization was performed using a colorimeter and high-performance liquid chromatography. Heavy metal detection was performed using an atomic absorption spectrometer. RESULTS: The acute toxicity study showed that the LD50 of the extract was greater than 5000 mg/kg. In the subchronic toxicity study, there were no significant adverse effects on food consumption, body weight, organ weights, mortality, clinical chemistry, hematology, gross pathology, or histopathology. However, a dose-dependent increase in the serum urea level was observed. The Ames test revealed that the extract did not have any potential to induce gene mutations in S. typhimurium, either in the presence or absence of S9 activation. Phytochemical analysis of the extract revealed high contents of phenolics, flavonoids, and tannins. High-performance liquid chromatography analysis revealed high levels of vitexin and isovitexin in the extract, and the levels of heavy metals were below the toxic levels. CONCLUSION: The no-observed adverse effect level ...

Role of three side support ankle-foot orthosis in improving the balance in children with spastic diplegic cerebral palsy

Cerebral palsy [CP] is a heterogeneous group of permanent, non-progressive motor disorders of movement and posture. Ankle-foot orthoses [AFOs] are frequently prescribed to correct skeletal misalignments in spastic CP. The present study aims to evaluate the effect of the three side support ankle-foot orthosis on standing balance of the spastic diplegic CP children. Thirty spastic diplegic CP children participated in this study from both sexes. They were divided randomly into two age and sex matched groups: [Group I: study group and Group II: control group]. The degree of spasticity was evaluated by passive movement for both limbs, while the child was completely relaxed. The Biodex stability system, was used for the assessment of the dynamic postural control of all diplegic children. Also the system measures the subject's ability to control the platform's angle of tilt. The patient's performance is noted as stability index which represents the variance of the platform displacement in degrees. Every patient in the study group was exercised on three side support ankle-foot orthosis for 30 min, three times weekly, for 6 months, also they received the same therapeutic exercise program which was given to the control group. The results revealed no significant difference as regards the pre-treatment mean values of all stability indices in both the control and the study groups [P < 0.05]. However comparison between post-treatment mean values of all stability indices in both groups showed significant improvement in favor of the study group [p < 0.05]. Uses of the three side support ankle-foot orthosis in addition to physical exercise program is highly useful in rehabilitation of spastic diplegic cerebral palsy children as they enabled them to gain more balance control and postural reactions

Unbalanced bone remodeling in Tunisian patients with inflammatory bowel diseases

Bone loss is an ignored complication in inflammatory bowel diseases. Its underling mechanisms are not fully elucidated. To investigate bone turnover in patients with inflammatory bowel diseases.The study included 67 patients with inflammatory bowel diseases and 54 age- and sex-matched healthy subjects. Urinary degradation products of C-terminal telopeptide of type I collagen, serum osteocalcin, parathyroid hormone, 25 hydroxy vitamin D and interleukin-6 were assessed. Bone mineral density was measured by dual energy-X-ray absorptiometry and osteoporosis was defined as T score < -2.5 SD. Patients showed significantly higher levels of C-terminal telopeptide of type I collagen and interleukin-6 and lower levels of 25 hydroxy vitamin D. Serum osteocalcin and parathyroid hormone were in normal range. In multivariate analysis, urinary degradation products of C-terminal telopeptide of type I collagen were associated with disease activity [p=0.04] and osteocalcin was associated with parathyroid hormone [p=0.04]. Urinary degradation products of Cterminal telopeptide of type I collagen and interleukin-6 were significantly increased in inflammatory bowel disease patients with osteoporosis. No association was found between osteoporosis and serum osteocalcin, parathyroid hormone and 25 hydroxy vitamin D. Bone resorption rate is increased and is associated with osteoporosis in inflammatory bowel disease patients. Inflammation, malnutrition, and hypovitaminosis D may contribute to the bone loss

Aminoacidopathies and organic acidurias in Tunisia: a retrospective survey over 23 years

Inborn errors of metabolism are neglected in developing countries because they are not as common as infectious and nutritional disorders. In Tunisia, no information is available on the incidence and epidemiological features of these inherited metabolic diseases. To precise the profile of aminoacidopathies other than phenylketonuria and organic acidurias and to estimate their incidences in Tunisia. Between 1987 and 2009, our laboratory received 13171 requests for analysis of patients with symptoms suggestive of inborn errors of metabolism. For these cases, ion exchange chromatography of free amino acids was performed on amino acids analyser. Urinary organic acids profiles were determined by gas chromatography-mass spectrometry. Abnormal cases were 370 [2.8%], divided into 212 cases of aminoacidopathies [57.3%] and 158 cases of organic acidurias [42.7%]. The most frequent aminoacidopathies, were maple syrup disease [32.5%], tyrosinemia type I [28.8%] and nonketotic hyperglycinemia [16%]. Methylmalonic aciduria [33.5%], propionic aciduria [18.4%] and 2-hyrdoxy glutaric aciduria [10.8%] were the most frequent organic acidurias. The incidences were calculated using the Hardy-Weinberg formula and were estimated at 1/13716 for maple syrup disease, 1/14804 for tyrosinemia type I, 1/16144 for methylmalonic aciduria and 1/23176 for propionic aciduria. Aminoacidopathies and organic acidurias turned out to be highly frequent in Tunisia, mainly because of a high rate of consanguinity. We believe that they are underestimated. To improve their diagnosis, it is necessary to have available sophisticated equipment which would allow early treatment of patients

Xerophthalmia in a traditional Quran boarding School in Sudan

To determine the prevalence of xerophthalmia at a traditional boarding school where children do not receive a diet adequate in vitamin A. A cross-sectional survey of 406 males residing in a Quranic traditional school was conducted using the World Health Organization xerophthalmia checklist. The association between the prevalence of night blindness and proportion of students staying at the school for 6 consecutive months and those eating solely at the school was investigated. The difference in age between children with night blindness and those without was investigated. Statistical significance was indicated by P<0.05. The prevalence of night blindness, conjunctival xerosis and Bitot's spots was 24%, 12.5% and 1%, respectively. None of the boys had corneal ulceration, corneal scars and corneal xerosis. No significant association was observed between the differences in mean age and development of night blindness [P=0.657]. There was a significant association between the duration of stay [cut-off of 6 months continuously] at the institute and the development of night blindness [P=0.023]. There was no statistical significance between regularly eating at the "maseed" and outside the "maseed" and the development of night blindness [P=0.75]. Children residing at a traditional school are vulnerable to developing xerophthalmia where the diet is inadequate in vitamin A. Institutional caregivers should be made aware of the importance of providing a balanced diet rich in vitamin A. Institutional caregivers should also be educated on the signs and symptoms of vitamin A deficiency for early detection of xerophthalmia