Risk-free point-of-care visceral leishmaniasis diagnostics: combining buffy coat microscopy and immunoassay in tertiary rural hospitals in Sudan.

Visceral Leishmaniasis (VL), a life-threating disease in Sudan and Eastern Africa, is usually diagnosed by a painful and invasive tissue aspirate microscopy. This study assessed the diagnostic effectiveness of buffy coat (BC) microscopy and the rK39 immunoassay test separately and combined as an easy non-invasive method applied to peripheral blood sample for field diagnosis of VL. 151 VL suspected patients were recruited from tertiary rural hospitals in Bazura, Gedaref state, from 2014-2015. All patients were tested for VL using rK39 ICT and microscopy smears from LN aspirate and BC in addition to PCR from BC as a reference standard test. Both BC and LN aspirate microscopy showed perfect specificity (100%) with false negative results, while the majority of true positives (81%) had a low-parasite burden. ICT showed almost perfect agreement but limited by its poor specificity. Each of these three tests is inadequate as a consistent single diagnostic tool and should be replaced by PCR in routine practice. Combining the results of risk-free BC microscopy and rk39 ICT, using peripheral blood sample, improved VL diagnosis with almost perfect agreement and 93.4% accuracy. Our findings indicate that combined BC microscopy and ICT are accurate, simple and easy point-of-care VL diagnostic tools in community and rural hospitals that can replace or reduce the use of invasive tissue aspirates microscopy, when PCR is unavailable. This is particularly of value in endemic rural areas, decreasing the delay in final diagnosis and preventing deaths caused by VL.

Detection of serum prostate specific antigen in lactating, pregnant, and advanced breast cancer Sudanese Women

Introduction: Although prostate-specific antigen (PSA) is the most valuable tumor marker for the diagnosis and management of prostate carcinoma; it is widely accepted that PSA is not prostate specific. Objectives: The aim of this study is to address the possibility of using the PSA as marker for the sex assignment in different categories and relevance of this test in women problems. Method: We have evaluated the measurement of serum total PSA for differentiation between Sudanese women with advanced breast cancer (n= 10); and those are lactating (n=10); pregnant (n=10) compared with 20 healthy women as control group. Serum total PSA (TPSA) was measured using immuno-radiometric assay (IRMA). Results: In this study the mean age was significantly higher advanced breast cancer groups compared with lactating group (P0.01). The mean serum PSA levels in the healthy control women examined (nsignificant high level of total PSA in serum of advanced breast cancer compared with the normal group (P 0.05). Conclusion: These results indicated the possible use of total PSA to distinguish between healthy women and/or women with advanced breast cancer

The effect of gum Arabic oral treatment on the iron and protein status in chronic renal failure patients under regular hemodialysis in Central Sudan

Objective To assess the effect of gum arabic (Acacia Senegal) oral treatment on the iron and protein status in chronic renal failure patients. Material and Methods Thirty-six chronic renal failure (CRF) patients (under regular hemodialysis); and 10 normal subjects participated in this study. The patients were randomly allocated into the following groups: Group A (n=12): CRF patients under low protein diet (LPD) (less than 40 gram/day); and gum arabic (50 g/day) treatment; Group B (n=14): CRF patients under LPD; gum arabic; iron (ferrous sulphate 200 mg/day) and folic acid (5 mg/day) treatment; Group C (control group; n=10): CRF patients under LPD; iron and folic acid treatment; Group D (n=10): normal volunteers who were kept on normal diet beside a daily dose of 50 gm gum arabic. Each of the above treatments was continued for three consecutive months. Predialysis blood samples were collected from each subject before treatment; and twice per month for three months. Hemoglobin (Hb); hematocrit; total protein; albumin; globulin and 24-hour urine volume as well as serum iron; total iron-binding capacity (TIBC);transferrin saturation; packed cell volume (PCV) and; mean corpuscular hemoglobin concentration (MCHC) were determined. Results Following administration of gum arabic oral treatment for three months; serum iron increased by 5.85and 4.81for groups A and B; respectively. These increases were significantly different from the baseline (P0.05); and control group C (P0.01). TIBC was significantly decreased in group A (4.44) and in group B (4.31) as compared with the baseline and control group C (P0.05). Transferrin saturation was significantly increased by 7.77; and 9.59for groups A and B; respectively; compared with the baseline (P0.05) and control group C (P0.01). Hb; PCV; MCHC; serum total protein; albumin and globulin; and 24-hour urine volume showed no statistically significant differences from the baseline and control groups. Conclusion The improvement in iron status due to oral administration of gum arabic could reduce the need for oral iron prescription