The cagA, cagE, vacA, dupA and iceA1 genes of Helicobacter pylori in Sudanese gastritis patients: Distribution and relationship with clinical outcomes and histological alterations

Aims@#Helicobacter pylori is a gastrointestinal bacterium that causes peptic ulcers and stomach cancer in nearly half of the world’s population. Many virulence factors influence the outcome of H. pylori related disorders. The purpose of this study was to see if there was a relationship between H. pylori virulence factors and histological and endoscopic findings in stomach biopsy specimens from Sudanese gastritis patients.@*Methodology and results@#In the period between March 2018 and January 2020, a total of 290 gastric biopsies were taken from patients in Khartoum State hospitals. Histopathology and polymerase chain reaction (PCR) assays were performed on all specimens. Histological investigation revealed H. pylori in 103/290 (35.5%) samples, while PCR revealed H. pylori 16S rRNA positivity in 88/290 (30.3%) samples. Eighty-eight positive PCR specimens were subjected to PCR for genotypic detection of cagA, cagE, vacA, dupA and iceA1 genes. All of strains were vacA positive 100% (88/88) followed by dupA 50.0% (44/88), cagA 40.9% (36/88), cagE gene 38.6% (34/88) and iceA1 gene was detected in only 15.9% (14/88). The vacA s1/m1 68.2% (60/88) was the most prevalent vacA subtype.@*Conclusion, significance and impact of study@#Helicobacter pylori virulence genes were widespread and diversified in Sudanese gastritis patients. Helicobacter pylori cagA and iceA1 were significantly in association with gastric mucosa inflammation degree, whereas the dupA gene was found to be associated with the clinical outcomes.

Índices de onda P na predição de recorrência de fibrilação atrial após isolamento da veia pulmonar / P wave indices to predict atrial fibrillation recurrences post pulmonary vein isolation

FUNDAMENTO: Índices de ondas P são marcadores interessantes para prever recorrências de fibrilação atrial (FA) pós ablação. OBJETIVO: Esse estudo avalia o valor dos índices de onda P para prever recorrências após isolamento da veia pulmonar (IVP) em pacientes com fibrilação atrial paroxística. MÉTODOS: Foram selecionados 198 pacientes (57 ± 8 anos, 150 homens) com FA paroxística sintomática refratária a medicamentos submetidos ao IVP em nosso hospital. Um eletrocardiograma de 12 derivações foi utilizado para medir a duração da onda P na derivação II, a força terminal de P (FTP) na derivação V1, o eixo e a dispersão da onda P. RESULTADOS: No acompanhamento de 9 ± 3 meses, as recorrências ocorreram em 60 (30,3%) pacientes. Os pacientes que apresentaram recorrência de FA tiveram maior duração média de onda P (122,9 ± 10,3 versus 104,3 ± 14,2 ms, p < 0,001), maior dispersão da onda P (40,7 ± 1,7 ms vs 36,6 ± 3,2 ms, p < 0,001). A duração da onda P > 125 ms apresenta 60% de sensibilidade, especificidade de 90%, valor preditivo positivo (VPP) de 72% e valor preditivo negativo (VPN) de 83,7%, enquanto a dispersão da onda P > 40 ms tem 78% de sensibilidade, 67% de especificidade, PPV 51% e VPN de 87,6%. 48/66 (72,7%) dos pacientes com FTP < -0,04 mm/segundo vs 12/132 (9%) com FTP > -0,04 mm/segundo tiveram recorrência de FA (p < 0,001). O eixo da onda P não diferiu entre os dois grupos. Na análise multivariada, os índices da onda P não foram independentes do tamanho do átrio esquerdo e da idade. CONCLUSÕES: A duração da onda P > 125 ms, a dispersão da onda P > 40 ms e FTP em V1 < -0,04 mm/sec são bons preditores clínicos das recorrências de FA pós IVP em pacientes com fibrilação atrial paroxística; contudo, eles não foram independentes do tamanho do átrio esquerdo e da idade.

BACKGROUND: P-wave indices are appealing markers for predicting atrial fibrillation (AF) recurrences post ablation. OBJECTIVE: This study evaluates the value of P wave indices to predict recurrences post pulmonary vein isolation (PVI) in patients with paroxysmal AF. METHODS: We selected 198 patients (57 ± 8 years, 150 males) with symptomatic drug-refractory paroxysmal AF undergoing PVI in our hospital. A 12-lead electrocardiogram was used to measure P wave duration in lead II, P wave terminal force (PWTF) in lead V1, P wave axis and dispersion. RESULTS: During a follow-up of 9 ± 3 months, recurrences occurred in 60 (30.3%) patients. The patients that had AF recurrence had longer mean P wave duration (122.9 ± 10.3 vs 104.3 ± 14.2 ms, p < 0.001), larger P wave dispersion (40.7 ± 1.7 ms vs 36.6 ± 3.2 ms, p < 0.001). P wave duration > 125 ms has 60% sensitivity, 90% specificity, positive predictive value (PPV) of 72% and negative predictive value (NPV) of 83.7%, whereas P wave dispersion > 40 ms has 78% sensitivity, 67% specificity, PPV of 51% and NPV of 87.6% 48/66 (72.7%) patients with PWTF < -0.04 mm/second vs12/132(9%) with PWTF > -0.04 mm/second showed recurrence of AF (p < 0.001). P wave axis was not different between two groups. On multivariate analysis, P wave indices were not independent from left atrial size and age. CONCLUSIONS: P wave duration > 125 ms, P wave dispersion > 40 ms and PWTF in V1 < -0.04 mm/sec are good clinical predictors of AF recurrences post PVI in patients with paroxysmal atrial fibrillation; however they were not independent from left atrial size and age.

Sacrococcygeal teratoma

Sacrococcygeal teratoma is one of the most common tumours affecting newborns and infants. Currently, a diagnosis is most likely to be made in the prenatal period during routine ultrasonography examination. Delay in diagnosis and treatment may lead to the development of complications, fetal loss and increased perinatal mortality. This case report investigates rupture of the tumour at birth, one of the complications of Sacrococcygeal teratoma. The baby in this case survived and showed a good postoperative recovery

An in-vitro assessment of anti-tumor activity of some plant extract and natural products, using potato discs bioassay technique

This study aimed to examine some plant extracts and natural products for anti-tumor activity. Potato disc bioassay was used to estimate anti-tumor activity of some plant extracts and natural products. Five plant extracts and natural products recommended in a questionnaire filled by local botanists in addition to an introduced fermented food [Manda Koso] were used in this study. A questionnaire was designed and filled by 60 botanists looking for plant extracts and natural products having anti-cancer activity. In addition, computer surveys were conducted for gathering information on promising natural compounds act as anticancer agents. The potato disc bioassay was conducted using the Complete Randomized Design with three replicates. Each treatment in each replicate was represented by two Petri dishes contained five potato discs each. Petri dishes treated with sterilized water were used as control. Four separate experiments were carried out using TLC technique. Results showed highly significant differences among treatments with respect to total number of tumors and inhibition average percentage [%]. The inhibition average percentage [IAP] for the different products ranged between 80.95-100% for the different products and equal zero for the control. It was 100% for Manda Kosa and bees honey followed by 90.23% for olive oil. Other treatments showed moderate anti-tumor effect of 80.95% IAP. Results concluded that Manda Koso, bees honey and olive oil have anti-tumor activity. Great association was found between anti-tumor activity obtained in this study and those published for anticancer activity of the promising material

Long-term results of non-union scaphoid fracture treated by volar bone peg autograft

The aim of this work was to determine the results of long-term follow up of surgical treatment of non-united fracture of the scaphoid using volar cortical bone peg autograft, harvested from the ipsilateral lower fourth radius. Material of this work included 57 cases. Fracture of the waist of scaphoid was encountered in 45 cases [78.95%]. Fracture of the proximal pole was present in 3 cases [5.26%]. Non-united scahoid with fragmentation of proximal pole and excessive arthritic changes were excluded from this study. Cases were evaluated for an average of 21 months after operation then follow up every year for long term study. The final end results according to Cooney score were 19 excellent [33.34%], 17 good, [29.82%], 13 fair [22.80%], and 8 poor, [14.04%]. Radiologically 46 cases showed complete bone union, while signs of non union were still present in 11 cases [19.30%], 6 cases [10.53%] of which the fracture was present in the proximal pole. Objectively, range of movement and grip strength were improved with union at the fracture site. This technique is a simple, cost effective and good option for management of non-united scaphoid fracture especially for waist fracture. All cases persistent with non-union developed arthritic changes of the wrist

Studies on the Sudanese indigenous African toad bufo SPP. [amphibia]: partial characterization of antibacterial peptides and proteins of the panotoid gland

The parotoid gland secretion of Bufo spp., obtained by manual compression, was found to contain 23.1-41.2% [w/w] of total protein. Gel filtration chromatography showed the existence of four fractions of peptides and proteins responsible for antibacterial activity. Thin layer chromatography showed seven Ninhydrin-positive spots in addition to the origin, in the parotoid gland secretion of Bufo spp. Sodium Dodecyl Sulphate Polyacrylamide Gel Electrophoresis revealed the existence, in the crude secretion, of 2 bands of proteins [P[1] and P[2]] and 2 bands of peptides [P[3] and P[4]] with various molecular weights

Glutathione alleviates the influence of n-nitrosamines on the activity of carcinogen-metabolizing enzymes in the liver of male mice

Most xenobiotics and carcinogens are metabolized primarily by the hepatic drug-metabolizing enzymes including cytochrome P450, cytochrome b5, arylhydrocarbon hydroxylase [AHH], and dimethylnitrosamine N-demethylase I [DMN-dI] as phase I drug-metabolizing enzymes. Therefore, changes in the activities of the above mentioned enzymes as well as free radical levels measured as thiobarbituric acid reactive substances [TBARS] were determined in the livers of sixty mice pretreated with glutathione [100 mg/kg], as antioxidant, before intraperitoneal administration of dimethylnitrosamine [DMN] [10 mg/kg], diethylnitosamine [DEN] [10 mg/kg], or methylpropylnitrosamine [MPN] [10 mg/kg] for seven consecutive days. Ten control animals received distilled water as vehicle for comparison with treated animals. The hepatic content of cytochrome P450 induced after treatment of mice with DMN, DEN and MPN while DMN, DEN, or MPN increased AHH activity. Also, cytochrome b5 content and DMN-N-dI induced after treatment with DMN or DEN. Interestingly, glutathione pretreatment restored the activities of the previously mentioned enzymes caused by DMN or DEN. On the other hand, DMN, DEN, and MPN depleted the levels of glutathione, and increased the levels of free radicals [TBARS]. DMN and DEN increased the activity of GST. Interestingly, pretreatment of mice with glutathione before administration of DMN, or DEN was found to restore the levels of TBARS and GSH to their normal levels. In addition, GSH pretreatments induced the activity of GST above the normal levels after administration of DMN or MPN except DEN did not change such activity. It was concluded that N-nitrosamines enhanced the activity of phase I and II carcinogen-metabolizing enzymes as well as increased the production of free radicals. The mechanism by which GSH restores the activity of carcinogen-metabolizing enzymes or free radical production to their normal levels is possibly due to induction of GST activity and/or a direct binding to the xenobiotic molecules

Balanites kernel oil for the treatment of dermatophytes: a clinical trial

In a previous in vitro study, we have shown that the kernel oil of fruits of the tree Balanites aegyptiaca referred to as Balanites kernel oil [BKO] is active against dermatophytes [i.e. superficial mycosis, ringworms, tineas [T. captitis, T. cercinata and T. pedis]. We report here our clinical trials with BKO. Trials were performed on patients presenting at Wad Medani Dermatology Teaching Hospital as well as primary school children in Elsoreeba Town [5 km south of Wad Medani]. Not all patients followed treatment till completely cured. Patients treated with BKO [half of the total] achieved complete cure in 3-5 weeks, on average, while those treated with the standard antifungal drug Miconazole [half of the total patients] did the same in the longer period of 3-8 weeks. Photographs showing progress of response to BKO treatments are included. BKO has great potential for development as a commercial drug for the treatment of dertmatophytes

In vitro studies on the potentiality of Balanites oil in the treatment of some superficial mycoses

Fruits of Balanites aegyptiaca are traditionally used in paste form for curing some skin diseases in few areas in Western Sudan. Our initial results pointed to the fruit kernel containing the active ingredient. Further studies were meant to test, in vitro, the effect of Balanites fruit kernel oil on three isolates which are known to cause superficial mycoses namely: Microsporum audouinii, Trichophyton soudanense and T. mentagrophytes. The three test organisms were subcultured on sabouraud's medium to which different concentrations of Balanites kernel oil were added. In addition to appropriate controls a normal vegetable oil viz. peanut oil, was tested. BKO, at 5% concentration, showed marked [>70%] growth inhibition against the three fungal isolates tested. No antifungal activity was observed in controls, including peanut oil. Two fractions of Balanites kernel oil were prepared namely: the free fatty acids [FFA] and the unsaponifiable matter [UM], and when tested for antifungal activity with the three test organisms, the activity resided exclusively in the free fatty acid fraction. Initial clinical studies on Balanites kernel oil, currently underway, largely confirmed our in vitro work described here

intelligence quotient IQ and growth among children with rheumatic heart disease

Rheumatic heart lesions continue to be a major health problem, especially among children in Egypt. Among the rheumatic heart children [aged 10-15 years], attending the rheumatic clinic of Pediatric Department, at Tanta University Hospital, it was found that, mitral valve lesions were more frequent representing 92.86% [41.43% cases of MR, 34.20% cases of DML and 17.14% cases of combined mitral and aortic lesions], and came next the aortic valve lesions, forming 24.29% of all cases [7.14% as single aortic lesions and 17.14$ were cases of combined aortic and mitral valve lesions]. The mean I.Q. was highest among cases of mitral incompetence 92.76% +/- 9.18, followed by cases of single aortic lesion 92.50 +/- 5.79, cases of double, mitral lesion 89.67% +/- 12.16 and lastly cases of combined mitral and aortic valve lesion 85.00 +/- 5.30, compared to 98.55 +/- 13.89 among controls, with significant difference between all cases and controls regarding I.Q. The I.Q. among cases was significantly correlated with growth measurements, serum protein and albumin, and blood heamoglobin. It was also correlated with the number of rheumatic fever attacks [reflecting excessive use of corticosteroids with no strict caution affecting growth inversely, especially prepubertal age], age of onset of first attacks and duration of brophylactic therapy [as the attacks occur early, the growth is mostly affected with complications like heart failure more liable to occur, with defective tissue perfusion], especially among cases of DML and combined mitral and aortic lesions. The growth measurements [including height, weight and span of arms], were significantly lower among cases than controls. Also, serum protein and albumin [reflecting nutritional status], and blood heamoglobin were significantly lower among cases than controls, and mostly affected among cases of double mitral lesions and combined mitral and aortic valve lesions