Association of Human Leukocyte Antigen (HLA) class II (DRB1 and DQB1) alleles and haplotypes with Rheumatoid Arthritis in Sudanese patients.

The aim of this study was to determine the Human Leukocyte Antigen (HLA) class II (DRB1 and DQB1) alleles and haplotype frequency in Rheumatoid Arthritis (RA) in the Sudanese population. The frequency of HLA-DRB1 and -DQB1 alleles and DRB1-DQB1 haplotypes were determined in 122 RA patients and 100 controls. HLA alleles were genotyped by the polymerase chain reaction-sequence specific primers (PCR-SSP) method. In RA patients, HLA-DRB1*04 and *10 alleles were high in frequency (9.6% vs 14.2%, P = 0.038 and P = 0.042, respectively), and dependently on anti-citrullinated protein antibodies (ACPAs) seropositivity (P = 0.044 and P = 0.027, respectively). In contrast, the frequency of the HLA-DRB1*07 allele was significantly low in patients than in controls (11.7% vs 5.0%, P = 0.010). Moreover, the HLA-DQB1*03 allele was strongly associated with RA risk (42.2%, P = 2.2x10-8), whereas, HLA-DQB1*02 and *06 showed protective effects against RA (23.1% and 42.2%, P = 0.024 and P = 2.2x10-6, respectively). Five different HLA haplotypes, DRB1*03-DQB1*03 (P = 0.00003), DRB1*04-DQB1*03 (P = 0.00014), DRB1*08-DQB1*03 (P = 0.027), DRB1*13-DQB1*02 (P = 0.004), and DRB1*13-DQB1*03 (P = 3.79x10-8) were significantly associated with RA risk, while 3 protective haplotypes, DRB1*03-DQB1*02 (Pc = 0.008), DRB1*07-DQB1*02 (Pc = 0.004), and DRB1*13-DQB1*06 (Pc = 0.02) were identified. This is the first study determining the association between HLA class II alleles and haplotypes and RA risk in our population.

T1/ST2 deficient mice display protection against Leishmania infantum experimental infection.

T1/ST2 is a surface marker selectively expressed on type 2 helper (TH2) effector cells. As Leishmania infection in susceptible BALB/c mice have ascribed to a polarized TH2 response, this study aim to investigate the T1/ST2 (the receptor for IL-33), as a typical TH2 marker in the postulation that a shift towards a beneficial TH1 response would occur in the absence of ST2. For this, ST2 knockout (ST2-/-) and WT BALB/c mice were experimentally infected in the retro-orbital sinus with L. infantum. We showed that ST2-/- animals displayed better control of parasite burden in both spleen and liver tissues at different time points of chronic phases, and reduced spleenomegaly and hepatomegaly compared with the wild-type (WT) mice. This was associated with increased in the IFN-γ levels and expression by CD4+ and CD8+ lymphocytes. The inflammatory response encompasses transaminases (AST and ALT) releases and NO productions were remarkably lower in ST2-/- mice compared with WT. These data suggest that, ST2-/-) exert protection against L. infantum infection and probably shift the immune response toward TH1 induction.

Outcomes of arteriovenous fistula for hemodialysis in Sudanese patients: single-center experience.

A well-functioning arteriovenous fistula (AVF) is essential for the maintenance of hemodialysis (HD) in patients with chronic renal failure. Our aim is to review our experience of creating AVF and to asses its success rate and common complication. A prospective, hospital-based study was conducted on 73 patients (48 males and 25 females) on chronic HD in Gezira Hospital for Renal Diseases and Surgery, from January to July 2007. Their mean age was 43.9 years (range from 18 to 72 years). Seventy-one (97.3%) of the study subjects had been dialyzed before creation of the AVF, 67 (91.8%) of them having undergone HD with temporary access. All patients (n=73) had a native AVF as the permanent vascular access (VA). A primary radiocephalic AVF was created in 78.1% of the patients, cubital fossa in 20.5% and one case had left snuff box AVF (1.4%). Percentage of AVF maturation was reported in 67.1% of the cases within the first six weeks and in 9.6% of the cases AVF never matured. Failure of AVF function occurred in 26% of the cases, due to thrombosis in 20.5% (n=15) and aneurysm in 5.5% of the cases. We conclude that an optimum outcome is likely when there is a multidisciplinary team approach, and early referral to vascular surgery is paramount.

Prostate specific antigen versus digital rectal examination as screening for CA prostate in Sudanese patients

Objectives: The aim of this study is to compare the value of digital rectal examination (DRE) and prostate specific antigen (PSA) determination in the detection of prostate cancer among Sudanese patients presenting with lower urinary tract symptoms (LUTS). Material and Methods: A prospective study was carried out in Gezira Hospital for Renal Diseases and Surgery in the period of June 2003- May 2005. Patients presenting with LUTS, had been screened for prostate cancer using PSA and DRE examination.. Serum PSA and DRE were measured in all patients. Trans rectal biopsy was performed if the PSA was over 4ng and /or abnormal DRE. Results: A total of 194 elderly male pa3ents presen3ng with lower urinary tract symptoms (LUTS), 140 of them were at last diagnosed as benign prostate hyperplasia (BPH) and 54 pa3ents were been confirmed with prostate cancer (PCa). Their mean age was 65 years (range 45-90). Elevated level of PSA (> 4 ng/ml) was found in all the patients with prostate cancer (n= 54) and 68.6% (n= 96) of BPH patients. The rate of prostate cancer detection showed to be 25.7% for PSA > 4ng/ml, 13.31% for abnormal (positive) finding of DRE, and 27.8% for combination of the positive DRE and PSA > 4 ng/ml. The rate of BPH detec3on showed to be 68.6% for PSA > 4ng/ml, 28.6% for posi3ve finding of DRE, and 4.1% for combination of the positive DRE and PSA > 4 ng/ml. Conclusion: It was found that PSA determination detects a considerable proportion of tumors missed by DRE. And the combination of PSA and DRE escalates the probability of prostate cancer detection,

The effects of gum arabic oral treatment on the metabolic profile of chronic renal failure patients under regular haemodialysis in Central Sudan.

This study aimed at assessing the effect of gum arabic (Acacia senegal) oral treatment on the metabolic profile of chronic renal failure (CRF) patients. A total of 36 CRF patients (under regular haemodialysis) and 10 normal subjects participated in this study. The patients were randomly allocated into three groups-group A: 12 CRF patients under low-protein diet (LPD) (<40 g day(-1)) and gum arabic (50 g day(-1)) treatment; group B: 14 CRF patients under LPD and gum arabic, iron (ferrous sulphate, 200 mg day(-1)) and folic acid (5 mg day(-1)) treatment; group C (control group): 10 CRF patients under LPD and iron and folic acid treatment and group D: 10 normal volunteers (on normal diet) under daily dose of 50 g gum arabic. Each of the above treatments was continued for three consecutive months. Blood samples were collected from each subject before treatment and twice per month "pre-dialysis" for 3 months. Biochemical parameters measured were: serum urea, serum creatinine, serum uric acid, serum calcium and serum phosphorus. By the end of the 3 months of treatment, serum urea levels significantly decreased by 31.2 and 44.18% for group A and B, respectively, compared with the baseline (0.01 < p < 0.001) and control group (p < 0.05). Serum creatinine levels significantly decreased in the groups of gum users (A, B and D) by 9.94, 12.65 and 11.7%, respectively, compared with the control group (p < 0.001). There was a significant decrease (p < 0.05) in serum uric acid levels by 14 and 19.9% for group A and B, respectively, compared with the baseline. Serum calcium levels increased by 12.64, 15.75 and 8.75% for group A, B and D, respectively, and these increases were significantly different (0.05 < p < 0.001) from baseline and control group for groups A and B. Serum phosphorus levels significantly decreased by 22.54% for group A, 17.69% for group B and 7.71% for group D, compared with the baseline (0.05 < p < 0.001). From this study, we conclude that oral administration of gum arabic could conceivably alleviate adverse effects of CRF.