Patterns of meningococcal infection in Sudan with emergence of Neisseria meningitidis serogroup W135

This study was conducted during the 2004-2006 epidemic of meningitis in Sudan to follow-up the frequency of disease outbreak or endemic waves and to evaluate the new quadrivalent vaccine for actual application. Samples were collected from Darfur, El Gedaref, Kassala and Khartoum States and transported to the National Health Central Laboratory in Khartoum. Of 196 patients with clinical symptoms and signs of meningitis, conventional culture identified Neisseria meningitidis in 37 [18.9%], confirmed by polymerase chain reaction. N. meningitidis type A was identified in 29 [78.4%] patients, type C in 3 [8.1%] and N. meningitidis W135 in 5 [15.5%]. The serotyping and molecular diagnosis patterns of N. meningitidis showed the emergence of the new strain,W 135, in patients from the borders of Sudan, 3 from the West Darfur, and 1 each from El Gedaref and Kassala. These could be related to the movement of pilgrims through the borders to Saudi Arabia in the Hajj season. Serious consideration may be needed for quadrivalent vaccination to prevent seasonal and Hajj season outbreaks

Bone mineral density in Egyptian adolescents and adults with short stature: results of a national survey

Little is known about bone mass acquisition among stunted adolescents who did not achieve their growth in height. A national survey was made of bone mineral density among stunted adolescents and adults. A multistage stratified random sample of 2500 families [8476 adolescents and their parents] was selected from 6 governorates in different geographical areas of Egypt. Clinical history, anthropometry and measurement of bone mineral density using dual energy X-ray absorptiometry was done. Mean T-scores were significantly lower among both adults and adolescents with short stature compared with those of normal height. The predictors of bone status among adolescent boys were age, body mass index [BMI], height attained [z-score] and maternal T-score and for girls were BMI, age at menarche, paternal T-score and z-score. Stunted adolescents suffered from low bone mass density and low stature adults suffered a high prevalence of osteoporosis

Pattern and severity of rheumatic valvular lesions in children in Khartoum, Sudan

We determined the pattern and severity of valvular involvement in 100 Sudanese patients with rheumatic heart disease [RHD] in 2 centres in Khartoum in 2003. All the patients underwent history taking, physical examination and Doppler echocardiography. The commonest lesions were mitral regurgitation [84%] and aortic regurgitation [40%]. Mitral stenosis alone was uncommon [9%] which could be due to a low detection rate related to the slow stenotic process and the subtle early signs. This, together with the inconsistent history of rheumatic fever, may lead to an underestimate of the prevalence of RHD. There was a strong correlation between severity of the lesion and irregular prophylaxis [P < 0.001]

Milk yield and growth performance of baladi and crossbred cows under north of nile delta conditions

Twenty four healthy lactating Baladi cows [local breed] and Friesian x Baladi cows [1[st] group] and their calves [2[nd] group] were studied during summer and winter seasons in North of Nile Delta of Egypt to investigate the effects of summer and winter conditions on the production efficiency. Milk yield [kg] during summer was lowest in the two breeds of cows when compared to values observed during winter. Lactating period was longer in crossbred than Baladi cows. Milk yield/day was higher in Friesian x Baladi than that in Baladi cows during both summer and winter. Milk components [fat, protein and total solids] were higher during winter than during summer at all times of testing, while an opposite trend was observed in milk lactose and solid non-fat [SNF] in the two breeds. Birth weight of calf and calf/dam percentage in Baladi breed was lower than the crossbreds during the two seasons. Breed of dam exerted a pronounced effect on birth weight, where purebred Baladi calves averaged 22.2, 24.8 kg which were lower than that crossbreds [31.0, 31.5 kg] during summer and winter, respectively that is not a maternal effect only it included the individual genetic effect as well. The calf/dam weight percentage in crossbred scored the highest percentage [7.36 and 7.32%] while the purebred Baladi calves means were 6.04 and 6.48% during summer and winter, respectively. The average weight of the animals in the two breeds increased as the animal grew with age; the increased weight during winter was greater than that during summer. The daily average growth rates during winter and summer were [0.487 vs 0.563 kg] and [0.475 vs 0.515 kg] in Baladi and crossbreds, respectively. In both breeds, live weight of calves at six months of age showed that, the calves which were heavier at birth [crossbred calves] were also heavier at six months of age. The means of calf weight at six months which were born during winter were greater than those born during summer. On the other hand, dam weight at calving, birth weight of calf, weaning weight for calf, average daily gain, lactation period and total milk yield were studied using records for Baladi and their crossbred cows covering the period from 1998 till 2007. Data were analysed for the effect of season and breed on milk production and growth performance

Validity of multiplex PCR as an emerging technique for diagnosis of enterotoxigenic Escherichia coli

Diarrhea continues to be one of the most common causes of morbidity and mortality among travelers and residents of developing countries especially infants and children. Enterotoxigenic E.coli is an emerging agent among pathogens that cause diarrhea. Enterotoxigenic E.coli produces either a heat-stable toxin or a heat-labile toxin, or both, encoded by plasmid-borne ST and LT genes, respectively. Diagnosis of infection with this subclass of E.coli can be performed with conventional biochemical reactions and API 20E system; however, the sensitivity and specificity of these methods are insufficient. A multiplex PCR assay that provides a sensitive and specific method for detecting the presence of either or both toxin genes has been developed. Two sets of primers were used to simultaneously detect the genes encoding LT and ST in order to detect all types of ETEC. The results for samples from patients indicated that the multiplex PCR assay had greater sensitivity and specificity than conventional biochemical reactions and API 20E system

Spectrophotometric determination of lamotrigine in pure form and in pharmaceutical preparations

Three simple and accurate methods are described for the determination of lamotrigine [LTG] in pharmaceutical preparations. The first method is based on the formation of an ion-pair complex between the drug and either of bromothymol blue or bromocresol green with subsequent measurement of the developed color at 4 12 or 410 nm, respectively. The second method is based mainly on the charge-transfer complexation reaction of this drug with either [sigma] acceptor iodine or [Pi] acceptor p-chloranilic acid. The colored products are quantitated spectrophotometrically at 365 and 560 nm for iodine and -chloranilic acid, respectively. The third method is based on the ternary complex formation between eosin or rose Bengal with copper [II] and LTG in phthalate buffer, followed by measurement of the resulting color at 560 or 570 nm for eosin or rose Bengal, respectively. Optimization of the different experimental conditions is described. The detection limits were varied from 0.16-1.63 micro g ml[-1] and the relative standarad deviations are less than 1.0%. Application of suggested methods to LTG tablets are presented and compared with reference HPLC method

Formulation and evaluation of famotidine sublingual tablets

Formulation of famotidine, rapidly disintegrated sublingual tablets, by direct compression was carried out. Fifteen tablets formulae were made in order to obtain suitable non-friable formulae, with disintegration time less than one minute and average crushing strength of 2-4 kg/cm2. The excipients used in the different formulae are Avicel pH 101, sorbitol, mannitol, lactose anhydrous, Ac-Di-Sol, magnesium strearate and saccharin sodium. The formulae prepared were tested for the effect of certain excipients on the hardness, friability and disintegration time. Tablets of 20 mg famotidine from the formulated and commercial oral dosage forms were administered to five healthy volunteers participated in the studs using a balanced cross-over design. Comparison of the mean urinary excretion, rats obtained after administration of both dosage forms indicated that in both cases, the rime taken to reach peak occurred at a mid point of 1.5 hours. Comparison of the cumulative amounts excreted in the urine after administration of famotidine in the two different dosage forms, resealed that about 5.49 +/- 1.06 mg of the administered dose [20 mg] was recovered unchanged in the urine during 12 hours following sublingual tablets administration. This value was found to be higher than that excreted after administration of Pepcid [R] oral tablets [4.6 +/- 0.65 mg] during the same period of time. Statistical analysis of the difference at P = 0.05, revealed nun-significant difference in the urinary excretion rate obtained of the two different dosage forms. On the other hand, a significant difference was found to exist in the total cumulative amount of famotidine excreted in the urine at 2 and 6 hours from both dosage forms. The results also indicated that there was no significant difference in AUC [0-12] between the two dosage forms

Nutritional stunting in Egypt: which nutrient is responsible?

We looked at the relationship between linear growth retardation and deficiencies of certain nutrients in Egyptian children. A group of 107 stunted children aged between 10 and 18 years were subjected to history-taking, physical examination and laboratory investigations. Selected cases were referred to radiology for assessment of bone age. Thirty-nine children were enrolled as controls. Serum haemoglobin, alpha-tocopherol, retinol and magnesium levels were significantly decreased in stunted children compared with the controls. Serum zinc levels were also lower in the stunted group but not significantly so. We conclude that several nutrient deficiencies occur simultaneously in stunted children and all of them may be responsible for stunting

Impact of nutritional rehabilitation on enzymatic antioxidant levels in protein energy malnutrition

To assess the role of enzymatic antioxidants in the pathogenesis of protein energy malnutrition [PEM] and the effect of nutritional rehabilitation, we studied 30 infants with PEM [mean age 10.63 +/- 4.39 months: 10 marasmic; 8 with kwashiorkor; 12 with marasmic kwashiorkor] and 15 controls. All underwent clinical examination and laboratory investigations, including superoxide dismutase [SOD] and glutathione peroxidase [GPx] estimation before and after nutrition rehabilitation. SOD and GPx were significantly lower in all malnourished infants compared to controls, and significantly increased after nutritional rehabilitation. These significant correlations suggest that antioxidants could be introduced during PEM nutritional rehabilitation to decrease morbidity and mortality

Soft drinks consumption among Egyptian children andadolescents

As a part of the national food consumption survey conducted in 1998 by the National Nutrition Institute, the consumption of soft drinks was determined among a sample of Egyptian children and adolescents aged 2-18 years using 24 hours recall method. It was found that a minority of the studied Egyptian children [9.9%] regularly consume carbonated beverages. Mean consumption was 215 +/- 59 ml/day. Consumption was greater among rural female children in the preschool age group, and urban adolescents. Energy intake 'was higher among those in the highest soft drink consumption category compared to non-consumers, Carbohydrate consumption was highest among those in the highest soft drink consumption category compared to the moderate and non consumers. While the mean protein, fat, calcium, vitamin C, zinc and iron intake was lowest among those who had highest soft drink consumption

Effect of frozen storage on the content of biogenic amines of the main edible parts of chicken

Chickens' meat, liver and gizzard were frozen at -20C for six months. Biogenic amines histamine, tyramine, tryptamine, cadaverine, putrescine and beta-phenylethylamine as well as trimethylamine, total volatile nitrogen, thiobarbituric acid and ammonia were determined in the fresh state and after three and six months during freezing. Biogenic amines were determined by HPLC as dansylamines. Histamine content was lower than the allowable levels [20 mg/100 g] after six months. Data indicated that tyramine, putrescine and histamine could be the most useful indicators for the frozen storage period in chickens' meat, however, cadaverine is the best one in liver. Tryptamine recorded a marked increase after six months in all tested samples

Differentiation of some saccharomyces species strains using diferent DNA techniques

Fingerprinting of total digested DNA using Eco RI could be used to differentiate between most of the yeasts under investigation. According to similarities of DNA banding pattern, Saccharomyces cerevisiae strains CBS 1464, CBS 2858 and CBS 2858-1 were identical. S. Cerevisiae 68 is the nearest strain to the previous three strains. The hand, S. Uvarum and S. diasticus were the most distant strains from the first three strains. There were a complete affinity between S. Cerevisiae strains CBS 1464, CBS 2858 and CBS 2858-1 and high affinity between S. Cerevisiae 68, S. carlesbergensis 34/70 and S. Dairensis. In addition, fingerprinting of digested mt DNA using Eco Rl showed the same criteria for the first three strains i.e. they are identical. On the other hand, strain S. cerevisiae 68 had complete different mt DNA. The nearest mt DNA to the mt DNA for the first three strains was that isolated from S. carlesbergensis

Compounding and testing of three modified elastomers as parenteral stopper

Tetramethylthiouram disulphide TMTD is known as vulcanizing agent alone or with mercaptobenzothiazole [MBT] in the presence of small quantity of sulfur. Different concentrations of TMTD were added to natural crepe and to bromobutyl rubber mixes in 0.5-3% w/w of rubber at different curing temperatures [140-160C]. It was found that the addition of 2% TMTD for each one of the two elastomers at 150C yielded products with good physicomechanical and swelling properties. When the vulcanizing system of 2% TMTD and 0.1% MBT was used, a delay in the cure time [Tc90] and an increase in the scorch time [TS2] were observed, the effect of blending the natural and bromobutyl rubber mixes in different% showed that increasing the natural rubber [NR] in the blends up to 40% arose the cure time and improved the physicomechanical and swelling properties. The optimal percentage was found to be 30% NR and 70% BR. Three formulations of natural [no 13], bromobutyl [no 14] and their blend [30NR-70BR] [no 18] were subjected to the suitability tests as parenteral stoppers. The results of aging indicated that the three elastomers possess good heat and oxidation resistance characteristics and are also suitable for sterilization. The suitability tests according to the international standards proved that the three elastomers have a suitable limits of physicomechanical and chemical properties

Effect of three rubber elastomers on the stability of amikacin and kanamycin in parenteral solutions

Three rubber elastomers [natural, bromobutyl and their blend] were prepared, exhibited good physicomechanical and chemical properties and suitable for use as parenteral stoppers. The effect of these elastomers on the stability of amikacin and kanamycin in solutions was investigated. The three elastomers were found to augment the loss of each antibiotic upon storage. The loss increased with time. The effect was more pronounced at 60C rather than at 25C. Bromobutyl elastomer showed the least determinative effect towards the antibiotic potency relative to the reference elastomer, as it exhibited the lowest sorption characteristics than the natural elastomer. Leached materials from rubber elastomers slightly affected the loss of antibiotics from solutions

Acute respiratory tract infections in children in Khartoum

Hospital data of the years 1979 to 1990 and case notes for a one - year period were reviewed to determine the pattern and time trend of morbidity and mortality of childhood acute respiratory tract infections [ARI] in Khartoum. About one third of the children's visits and 40% of the admissions to Khartoum Children's Emergency Hospital were due to ARI. Out of 63514 cases admitted with pneumonia, 37.3%, 47.9% and 14.9% were aged under one year, 1 - 4 and 5 - 14 years respectively. 1696 children died giving a mean [SD] case, fatality rate [CFR] of 2.69% [0.71]. The CFR was high [4.04%] among infants and was higher in girls compared to boys in the age group 1 - 4 years

pattern of childhood tuberculosis in Khartoum

We report on a study undertaken to determine the current trend in epidemiology, clinical picture and outcome of childhood tuberculosis. A total of 88 cases of tuberculosis were admitted to two teaching hospitals in khartoum, during 1990 - 1991. Fifty-seven [65%] of the cases belong to families of poor socioeconomic status. The mean [SD] age was 7.8 [4.4] years; only 26 [30%] had history of BCG vaccination and anemia was present in 62 [70%] of the cases. The tuberculin reaction was negative in 11 [12%] of the patients and radiological evidence of tuberculosis was observed in 64 [73%] of the cases. Out of all the cases, 62 [70%] were children with pulmonary tuberculosis and four of them had smear-positive sputum for acid and alcohol fast bacillus. The non pulmonary cases comprised lymphatic [21%], abdominal [7%], and meningitic [2%] tuberculosis. Three out of four patients with tuberculous meningitis and two of the five cases with miliary tuberculosis died. The outcome of 30 [37%] of the patients who completed one year follow up was favorable. Effective programme of immunization of all infants, high index of suspicion to diagnose and effectively treat tuberculous cases in the early [primary] stage and efforts to improve patients compliance to treatment are best addressed within the national programme of tuberculosis ideally incorporated in the programme of primary health care in the community

Comparative study of intravenous aminophylline, subcutaneous adrenaline and nebulized salbutamol in the treatment of acute asthma in children

One - hundred and twenty children presenting with acute asthma were studied. There were 73 males and 47 females, aged between 5 and 12 years. The patients were randomized into three groups to receive either subcutaneous adrenal in [AD], intravenous aminophylline [AN], or nebulized salbutamol [SAL]. Forty patients were examined in each group. Vital signs, pulmonary function [PEFR] and clinical assessment were recorded prior to treatment and repeated at 10, 30, and 120 minutes [min] after treatment. There was no significant difference between the groups in age, sex, height or baseline PEFR. Each group showed highly significant improvement in PEFR at 10, 30 and 120 min compared to the baseline. Between groups, SAL produced PEFR response near its maximum value at 10 mitt and it was significantly better than that of both AD and AM at both 10 and 30 min. It was equipotent to that of AM at 120 sin. Adrenaline produced a response similar to AM at 10 mm. but it caused significant tachycardia and tremors. Salbutamol aerosol proved to be an effective and tolerable bronchodilator in the treatment to be used in emergency units of regional hospitals. Adrenaline, also potent, but much less expensive than SAL remains the drug of choice for nation - wide use in all health units in the country