كلية علوم المختبرات الطبية

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A New Simple And Cheap Method For The Eradication Of Transfusion — Induced Malaria In Sudan
(Neelain University, 2004) Mohamed Siddig Mohamed Ali
ABSTRACT Background: Transmission of malaria through blood transfusion is a genuine problem for the capability of plasmodia to survive in stored blood and the weakness of transfused patients. Systemic screening of blood donors is not a practical solution of the problem even by using an advanced technique as well as treatment of transfused patients after transfusion and/or prospective donors before donation. Therefore, an ideal way for such prevention could be to kill the parasite in donors’ blood before transfusion. Objective: To select the antimalarial drug of choice that can be routinely added to donors’ blood in vitro to kill malaria parasites within maximum three days. Material and Methods: Donors’ blood which was collected from 4484 blood donors has been screened for malaria parasite microscopically using Giemsa’ staining technique. Of these samples, only 30 (500ml of blood each) satisﬁed the inclusion criteria of this study. Each of these blood samples was subdivided equally into ten sub-samples to obtain a total of 300 sub- specimens. Three concentrations of each antimalarial drug (chloroquine, fansidar and quinine) were added to 30 specimens while 30 specimens (control) were leﬁ without adding antimalarial drug. Blood specimens were tested for parasite culture, platelets count, total leucocyte count, packed cell volume, lysis percentage, osmotic fragility, prothrombin time, activated partial thromboplastin time, sodium and potassium serum levels simultaneously on the day of collection. Thereafter, it was stored in the blood bank refrigerator (4°-6°C) and tested after 24 & 48 hours by the same laboratory procedures. Results: The reduction of malaria parasites numbers was found to be proportional to the concentrations of chloroquine, fansidar and quinine added to donors’ blood and to the storage period. Whereas, the control donors’ blood samples (without antimalarials) revealed stable number of the parasites even after 48 hours storage. Fansidar was highly effective aﬂer 24 hours storage followed by quinine and 48 hours storage revealed high effectiveness of fansidar followed by quinine and chloroquine. The optimal doses of the applied antimalarial drugs were generally safe to all constituents of the stored blood compared to the control blood samples. Conclusion and Recommendation: It was concluded that for eradication of transfusion induced malaria by in vitro processing of donors blood, fansidar is the best drug that can be used followed by quinine. So it was recommended to apply the optimal doses of these drugs to the components of the blood bags before phlebotomy.
Prevalence of Intestinal Parasitic Infections among Displaced Children in Kassala Town
(Neelain University, 2005) Marnoun Magzoub Mohamed Osman
ABSTRACT Four hundred and ﬁfty faecal specimens were collected from 450 displaced children around Kassala town aged from 6 moths to 13 years old and examined under microscope for the detection and identiﬁcation of intestinal parasites. Microscopical examinations by two techniques were done (wet preparation and concentration technique by simple centrifugation). The exarnination explained that 80 (17.8%) Were found to harbour stages of infective parasites. Four species of infective parasites were identiﬁed from individuals in all areas (displaced areas). These comprised the following Giardia lamblia (12.3%), H. nana (4.9%), E. histolytica (0.4%) and T. trichiura (0.2%) Out of 450 stool samples collected from children in urban area (Waw—nour) inside Kassala town 45 were found to harbour cysts trophozoites or eggs of pathogenic parasites. This constituted on overall prevalence (10%), two species of pathogenic parasites‘ were identiﬁed from individuals in Waw-nour (urban area). These comprised the following: G. lamblia (08%) and H. nana (02%). The factors responsible for the spread of diseases include the low standard hygiene and environmental conditions and the lack of proper disease control measures. Also a comparison between two mentioned techniques was done on all specimens: displaced children specimens and urban children specimens
Isolation of Some potentially Pathogenic Bacteria From the Upper Respiratory System Khartoum Hospital Staff and patients
(Neelain University, 2005) Hana Mohammed Ahmed ..
Abstract ‘ 100 sample from throat and nasal cavity were cultured for aerobic bacteria. Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus viridans, E.coli and Klebsiella pneumoniae were isolated from nasal cavities and throat specimens of healthy medical stall, patients and eo- patients who were not suffering from symptoms ol’ respiratory disorders;the presence~=of these organisms indicated acquired and nosocomial transmission within hospital environment as those are not normal microbiota ol’ the throat. Isolation of pure -isolates as 56.9% from volunteers and 43.1% were mixed isolates .'l‘he aerobic growths were idcntilicd as Gram- positive bacteria which were l‘urther identiﬁed as Stupl1ylococcus aurcus (21.1%), Staphylococcus cpiu'ermidi.s' (36.8%), Staphylococcus saprophyticus( l 4.0%), Streptococcus pneumo/1iac(5 3%), Streptococcus viridatts (19.3%) and Corynebactcrium spp (3.5%). Gram-negative bacteria were identiﬁed as ’E.c0li (42.9%) and Klebsiclla pncuntoniue (57.1%). Nasal specimens revealed isolation 01' Staphylococcus aurcus, I5. colt, Klebsiella pncumoniae and Pscudomonas aeruginosa which are not among normal llora of the nasal cavitis and considered as potential pathogens. The aerobic growths were identilied as Graln- positive bacteria which were further identiﬁed as Staphylococcus aureus (20.6%), Staphylococcus epidermidis(55.5%), Streptococcus pneum0niae(7.9%), Streptococcus viria'zm.5' (7.9%), Other /J’-hacmolylic s//'epI1__1c0cci (3.3%) and Corynebaclerium spp (4.8%). Gram-negative bacteria were identiﬁed as E.c0li (14.3%), Klebsie/la pnezlmoniae (42.9%), I’.s'cud0/no/1u.v zle!'z/gilwsa (28.5%) and Neisseria spp(l4.3%).ls0lated bacteria showed markedly low inhibition zones towards antibiotics . Staphylococcus aureus in all test antibiotics showed resistance and inhibition zone ranged between 3-l lmm, pencillin gave a small inhibition zone. Iicoli showed resistance towards Clindamyein and amoxicillin. I’seuu'0mona.s' ucrugi/10.s'u showed resistance toward nitroﬂoxacin ,clindainyein and amoxicillin while Klcbsiella pneumoniae was resistant to nitroﬂoxicin , clindamycin, amoxicillin and tetracycline
EVALUATION OF THE ANTIMICROBIAL ACTIVITY OF SOME SUDANESE PLANTS AGAINST M Y C OBA C TRI UM TUBERCULOSIS
(Neelain University, 2005) RASHID ABDALLA AHMED HASSOUNA
Abstract This thesis investigates the antimicrobial activity of some Sudanese plants used in folk-medicine against Mtuberculosis. Preliminary screening was carried out using twenty plants, which grow in Sudan and used in folk~medicine for their effects on some microbial infections. The screening revealed that the petroleum ether extracts (non-polar extracts) possess no activity at the concentrations screened, while the methanolic extracts (polar-extracts) of these plants have a weak activity against M tuberculosis. An experiment was designed to compare the in-vitro activity of two drugs of choice used for treatment of tuberculosis (Streptomycin and Rifampcin) with the activity of the plants’ extracts. A series of in-vitro sensitivity tests were conducted to evaluate the effect of combined therapy, consisting of the methanolic extract of each plant plus Streptomycin on Mtuberculosis. The results revealed that thirteen methanolic extracts have a positive effect on M tuberculosis when mixed with Streptomycin. The minimum inhibitory concentration (MIC) of each extract was determined. The results indicated that the most effective plants’ extracts are Asphodelus tenuzfolius (Burwag), Nigella sativa L (Black Kamoon) and Kigelia aﬁicana (Um-Shotour).
GENOME WIDE SEARCH FOR VISCERALLEISHMANIASIS SUSCEPTIBILITY GENESIN SUDANESE POPULATION
(ALNEELAIN UNIVERSITY, 2005-10) MANAL AHMED MOHAMED AHMED FADL
ABSTRACT Sudan is one of the major foci of visceral leishinaniasis (VL) globally (the other two foci are Brazil and India). Familial clustering and ethnic differences suggest genetic factors may be involved in the infection. In this study a two stages genome-wide scan was employed using two independent sets of families from two villages: El-Rugab and Um—Salala. located 40 kilometers apart in the heart of the endemic area of eastem Sudan. These villages are inhabited by the Masalit ethnic group who migrated from westem Sudan in the 1980s. In the ﬁrst stage (= scanl) we genotyped 400 highly polymorphic microsatellite markers (approximately 10 cM apart) in 220 individuals from 38 multicase pedigrees (= scanl families) comprising 48 nuclear families (1 18 affected sibs). Scan] was followed by grid tightening strategy in which 35 additional markers were added close to regions that gave suggestive evidence for linkage of VL susceptibility in scan 1. These markers were typed in scanl families. ln the second stage (scan2). 20 markers from positive regions of linkage and the 35 additional markers were all typed in family set 2 (=scan2 families: 21 nuclear families, 48 affected sibs). ln scan 1, the multipoint analysis performed provided evidence for linkage of VL susceptibility to 5 regions on chromosome lp22, ]q3l.3. 5q34-35.3, 6q27 and l3q 31.1 (0.0002
pseudomonas aeruginosa Infection in Poultry
(Al Neelain University, 2005-12) Alrouda Khalafalla El Shaﬁe
Detection of Chlamydia lrachomalis in Urine Specimens by Polymerase Chain Reacﬁon in Pregnanl Women wilh Vaginal Discharge in Omdurman
(Neelain University, 2006) Mohammed Nafi Hammad Manzool
Chlamydia trachomatis infections are now recognized as the leading cause of sexually transmitted diseases (STD). It is known to be subject to cervicitis, pelvic inﬂammatory disease (PID), infant conjunctivitis, infant pneumonia and urethritis. If left untreated properly they can lead to severe squeal in women such as pelvic inﬂammatory disease, ectopic pregnancy, and tubal infertility. Babies born to chlamydia infected mothers are at high risk of developing inclusion conjunctivitis and pneumonia. Several methods are available for the detection of C. trachomatis in clinical specimens, such as Giemsa staining, cell culture, direct antigen detection, and nucleic acid probe. Recently polymerase chain reaction (PCR) technology has been focusing on the diagnosis of infectious diseases. It can also provide a rapid, convenient and sensitive detection of C. trachomatis in clinical specimens. The aim of this study was to estimate the prevalence of Chlamydia trachomatis infections, among pregnant women, using polymerase chain reaction, during the period of 2004 and 2006, to asses the pattern of chlamydia infections. Atotal number of one hundred and ﬁfty two pregnant women attending Omdunnan Maternally hospital, were involved in this study. The study group had an age average between l6 and 43 years with a mean of 27.9 years. About 10.5% of the study group were in the ﬁrst trimester, while 32.6% and 57.9% were in the second and third trimester respectively. The frequency of Chlamydia trachomatis infections, using polymerase chain reaction, was 16.4% (25/ 152) among studied group. Previous history of abortion was detected in 43.4% of study population, 52% of them have Chlamydia trachamatis infections. Frequency of polyuria was detected in 74.3% of study population, 84% of them have Chlamydia trachomalis infections. Dysuria was detected in 7.2 % of study population, 16% of them have Chlamydia t/‘ac/zoznaris infections. Pyuria was detected in 78.9% of study population, 80% of them have Chlamydia trachomatis infections
PCR Versus Conventional Methods for Detection of Mycobacterial tuberculosis in Histologic. Specimens in Makkah Area
(Neelain University, 2006) Omar Bashir Ahmed Mohammed
Abstract Tuberculosis (TB) causes more deaths than any microbial disease. In spite of signiﬁcant advances in prevention and drug treatment, TB still remains a major public health threat. So that there is a need for a rapid, sensitive, and more speciﬁc methods for TB diagnosis for effective and early treatment specially in areas of high number of visitors and immigrants like Makkah area in Western part of Saudi Arabia. TB was evaluated in 50 tissue specimens, taken from 50 patients in Makkah area. A polymerase chain reaction (PCR)-based assay and regular methods (acid-fast bacilli “AFB” stain, TB-culture, histopathology examination) were used. Results detected by all theses methods as follows: TB- PCR was positive in 32(64%), (AFB) stain was positive in l7(34%), TB-culture was positive in 30(60%), histological examination was positive in 26(52%). When done comparatively to the TB-culture, PCR for MT DNA in 50 tissue samples was 100% sensitive and 90% speciﬁc. AFB stain showed low sensitivity 50.0% and with speciﬁcity 90.0%, histological examination sensitivity was 80.0% and speciﬁcity 90.0%. These data indicate that PCR ampliﬁcation is l.1S8ﬁ1i for detecting MT DNA in histologic specimens as it is rapid and sensitive. Also it can be used to increase diagnostic accuracy in patients who have confusing diagnostic problems associated with granuloma tissue response. It also offers the possibility of the teclmique being carried out in ﬁxed histologic specimens that may not identify the MT by regular methods.
Laboratory Diagnosis of Male Infertility among Sudanese Couples
(Alneelain University, 2006) Abdalmula Mohammed Abdalla
ln view of the increasing number of infertility among the couple male present in the Sudan .This study was conducted to essentially study the factors responsible for decreased male fertility, the impact of toxic and antioxidant elements on male reproductive function .and to introduce biochemical markers to be used in male infertility diagnosis . Group of 500 infertile male subjects were enrolled ;15O azoospermic 150 oligospermic patients, 100 patients with abnormal sperm motility and 100 patients with abnormal sperm morphology were studied, and compared with reference group of 100 fertile male. The fertility and thyroid hormones were measured by ELISA and trace elements in semen and serum/blood by AAS. Semen volume and liquefaction time in azoospermic and oligospermic patients was significantly reduced (p< .05 ). Signiﬁcant correlation was noticed between both FSH & LH with seminal volume , and blood Pb with liquefactions time in azoospermic patients .Signiﬁcant correlation was observed between seminal Zn and liquefaction time in both azoospermic and oligospermic subjects.(r < .05). Immunological infertility is higher in patient with abnormal sperm motility (9% lgC-3, 6% lgA) than other test groups. Testosterone in the test groups was significantly reduced , while FSH level was signiﬁcantly increased (p<.O5). Prolactin level was increased in azoospermia, and significantly increased in the other infertile groups (p<.O5). LH was significantly increased in both azoospermic and oligospermic patients (p<.O5) Significant correlation was noticed between ,LH and semen Cd in azoospermia , prolactin was signiﬁcantly correlated with Pb in both blood and semen, and with seminal Mn and Zn, LH with seminal Zn in oligospermic patients. Also correlation between, prolactin with blood Pb and FSH with blood Cd in abnormal sperm motility patients (r<.05), .The thyroid hormones showed conﬂicting levels in the infertile test groups, only T4 was slightly increased. In seminal plasma Cd level was significantly increased in both azoospermic and oligospermic patients (p < .05). Seminal Pb level was slightly elevated in infertile patients with azoospem1ia and oligospermia . Zn level was signiﬁcantly reduced in the infertile groups (p<.O5). Se , Mg & Ca were signiﬁcantly reduced in both azoospermic and oligospermic patients (p<.O5). Where as Mn, Ni, Co,Cr and Cu showed no signiﬁcant variations .ln blood Pb level was increased in the test groups, and Cd level was signiﬁcantly increased in azoospermia (p<.O5), and the other elements indicated conflicting level , _but within normal range when compared with control group. Pb level was significantly correlated in blood and semen of azoospermic and oligospermic subjects,Also Cd level was significantly correlated in both semen and blood of abnormal sperm motility patients (r<.O5). Seminal NAG was significantly reduced in the study groups , while citric acid was reduced in both azoospermic and oligospermic patients (p<.05).Semen fructose indicated conflicting level ,but within normal range .Significant correlation was noticed between NAG with both FSH and LH in azoospermia, and with prolactin and seminal Mg in oligospermia (r<.O5).2.7% of azoospermia had sertoli-syndrome , explained significant decreased in testosterone ,seminal NAG, citric acid Zn, and increased FSH. (P<.O5). 13% of the infertile have varcocele, recorded significant increased FSH,LH and decreased seminal NAG ,citric acid 8- Zn (p<. 0 5). 9.6% of the test groups had erecting and ejaculating problems. Characterized by signiﬁcant increased in prolactin and Mn level.7.2% of the test groups are smokers, explained significant increase of both Cd and Pb in blood and semen, and reduced semen volume, NAG and Zn level (p<.05) Treatment of adult male rats with Cd, Pb caused hair loss and enlargement of the testes. Followed by signiﬁcant increased of blood Cd , blood Pb, FSH and LH (p<.05), decreased testosterone and Zn (p< .O5).With blockage of spermatogenesis at seminiferous tubules level, maturation arrest ,and proliferation of the sertoli cell. Where as treatment with Zn, showed increased number of germs cells and developing spermatide .Mixing of Cd with Pb in one dose exacerbated the toxic action of this elements, caused decreased testosterone and Zn, increased FSH , LH and prolactin with deletion of the germ cell, and proliferation of the sertoli cells . While mixing of Zn with Cd and Pb , reduced the toxicity of this elements on fertility hormones, development of the germ cell, and proliferation of sertoli cells
Homocysteine in Health and Disease in the Sudan
(Neelain University, 2006) Sami Habiballa Abdalla
Abstract Introduction and background: Homocysteine is a non-protein-forming sulphur-containing amino acid ‘that is derived exclusively from methionine. It was ﬁrst synthesized in 1932 by du Vigneaud and Butz. It can be degraded in the transsulphuration pathway to cystathionine or remethylated to methihnine via the remethylation pathway. Folic acid and vitamin B12 inﬂuence homocysteine metabolism as cofactors in these two pathways. During last few decades evidence has highlighted the role of elevated levels of plasma homocysteine (hyperhomocysteinemia), as an independent pro-thrombotic risk factor for cardiovascular diseases, especially coronary heart disease and venous thromboembolism. However, the mechanism(s) whereby elevated levels of homocysteine promote thrombosis has not been clariﬁed yet. Earlier studies on the relationship between homocysteine and disease were done in many ethnic groups worldwide, but nor in Sudan. The current study, was undertaken in Sudan, where the prevalence of cardiovascular and thromboembolic diseases is assumed to be lower than in Westem countries. Objectives: The objectives of this study were (1) To introduce the EIA method of measurement of homocysteine in blood. (2) To work out the normal values of plasma homocysteine in Sudanese healthy population. (3) To study the effect of some normal physiological factors on plasma homocysteine levels in Sudanese healthy population. (4) To study the role of hyperhomocysteinemia as a risk factor of thrombosis in Sudanese patients as well as recurrent malaria. (5) To evaluate the relationship between malnutrition in children (low Bu and folic acid) and homocysteine levels. Material and Methodlv: A total number of 146 Sudanese patients were enrolled and distributed into following four groups: (i) Patients with Coronary heart disease (Cl-ID) (n=50), (ii) Patients with current malaria (n=50), (m) Patients with recurrent venous thrombosis (RVT) (n=26) and (iv) Children with protein-calorie malnutrition (n=20). Also 200 apparently healthy Sudanese subjects were recruited to represent the control groups. The following assays were carried out: (a) total plasma homocysteine, using EIA technique, for all participants (b) serum levels of folic acid and vitamin B1; for children participants. Results: Our study showed different in plasma homocysteine levels between males and females (Adults: males, 8.421i4.082 vs. females, 7.273:t:2.398 umol/1; P>0.05, children: males, 5.8li1.93 vs. females, 5.62:h2.08 umol/1; P=0.736), but the difference was not statistically signiﬁcant. The levels of plasma homocysteine was found to be signiﬁcantly higher in all the studied patients than in the control subjects (CHD patients vs. controls: 17.64:hl 1.68 vs. 7.85i3.39 umol/1; P<0.000l, RVT patients vs. controls: l5.06il0.55 vs. 7.85:k3.39 pmol/1; P<0.002. CM patients vs. controls: 13.61i4.82 vs. 7.85:h3.39 pmol/1; P<0.0001, P- CM patients vs. controls: 8.4l:t1.6l vs. 4.26il.l8 pmol/l; P<0.000l). We found that the mean serum vitamin B1; levels were signiﬁcantly higher in the control group than in children with P-CM (290.5il 15.66 vs. 72.55:h26.l3 pmol/1; P<0.000l). Also, the serum folic acid levels were signiﬁcantly higher m the healthy group (l3.38;E2.67 nmol/l) than in patients with P-CM (6.36 i2.63 nmol/l; P<0.000l). Conclusion and Recommendation The results led us to conclude: - Hyperhomocysteinemia is an additional risk factor in Sudanese patients with CHD, RVT, as well those with current malaria. - The hyperhomocysteinemia recorded in children with protein- calorie malnutrition, is closely associated, with signiﬁcantly reduced serum levels of folic acid and vitamin B12. - The introduction of the EIA plasma homocysteine measurement is recommended in the routine investigations of patients with l thrombo-embolic diseases as well as those with current malaria and children with protein-calorie malnutrition.
solation of Potential Pathogenic Bacteria From Delivery and Nursing Rooms at Certain Hospitals
(Neelain University, 2006) Amani Mohamed Ahmed Elagbash
Abstract Out of the seventy — nine randomly collected air samples from delivery rooms at four hospitals (Khartoum, Omdumian Matemity, Ahmed Fadul and EL Mribat) 63.3% showed positive bacterial growth. On the other hand out of 60 air samples that were collected from nursing rooms of the same hospitals 66.7% of them showed positive bacterial isolation. The isolated bacteria were identiﬁed as Staphylococcus aureus, E. coli, Klebsiella spp, Pseudomonas aeruginosa and Bacillus spp. The highest percentage of isolation was recorded in Khartoum Hospital as 50.6% and 42% in delivery and nursing rooms, respectively. Staphylococcus aureus and Pseudomonas aeruginosa were the most dominant organisms isolated from the delivery rooms at all examined hospitals. While Staphylococcus aureus also showed highest percentage of the bacterium that was isolated from nursing rooms at Omdumran Matemity Hospital and EL Rhibat Hospital, E. c0lz' was dominant in Khartoum Hospital nursing rooms and Bacillus spp was the dominant organism isolated from nursing room at Ahmed Fadul Hospital. The isolated bacteria showed clear resistance toward the common Hospital used antiseptics.
Prevalence 0f@Lupus Anticoagulant in Sudanese Ladies with Recurrent Pregnancy Loss.
(Neelain University, 2006) Tagreed Mohammed Osman.
ABSRTACT This study, was done to detect Lupus Anticoagulant in titty patients with three or more recurrent pregnancy losses, from Khartoum Teaching'Hospital, Omdonnan Teaching Hospital, and Khartoum Fertility Centre. The study was carried out in the period from February to July, 2004. Twenty women with nomtal obstetric history, matched to the patients in age and socioeconomic status, were included as controls. The tests used for detecting the Lupus Anticoagulant were the dPT, dAPTT, dRRVT, KCT, and PNP. The study showed that two of the patients (4%) had Lupus Anticoagulant as suggestedby prolonged dAP'I'T, which was not corrected by mixing with normal plasma and was shortened by PNP. No abnormal results were obtained in the controls. The study also showed that although the mean of dAPTT, of the LA positive patients was signiﬁcantly elevated compared to the LA negative patients (P<0.05), the means of dPT, dRWT, and KCT of LA positive patients compared to LA negative patients showed no statistical signiﬁcant difference (P>0.005). So our results indicate the dAP'lT is more sensitive in detection of LA than KCT or dRWT.
SERO- DETECTION OF HEPATITICS B, HEPATITICS C AND SALMONELLA MICROORGANSMS AMONG SUDANESE SCHISTOMIAASIS PATEIEN IN GEZIARA
(Neelain University, 2006) MAZIN OMAR MOHAJER
This cross-sectional study was conducted to determine the relationship between schistosomiasis , salmonellosis, Hepatitis B, and Hepatitis C infections in Helate Mahajoub in Gezira Agricultural Scheme . ' Idrine and faecal samples were collected from 288 individuals and‘ inpyestigatcd for Schistosomaova using the modiﬁed Kato thick smear technique and the concentration technique. A serosurvey of 207 subjects was conducted to diagnose S.typlzi, S.paratypI1i A, and S.paratyplzi B using the Widal test technique. Hepatitis B surface antigen (HBsAg) and Hepatitis C antibodies were estimated using the immuno chromato- graphic technique (ICT). The scro-positivity of HBsAg and HCV antibodies were 21.7% and 9.1% respectively; while enteric fever showed a 30.9% sero- positivity. i The association established in this study may be explained by the immune status of the infected subjects studied
THE FREQUENCY OF Kell Red Cell Antigens (K&k) Among THE Major SUDANESE TRIBES
(Al Neelain University, 2006-09) AHMED SIDDIG OKASHA
The Kcll blood group system is complex containing over 20 different antigens with high and low incidence. The Kell antigens are located on a single red cell transmembrane glycoprotein, encoded by 19 exons of the Kcll gene. Kell gene is carried on chromosome 7 and is located at 7q33. Kell blood group system is the most important blood group antigens after Rh antigen because the Kell antigens are highly immunogenic and the corresponding antibodies are significant in transfusion reactions and HDN. This study was carried out on 500 random samples to determine the frequency of Kell-l and Kell-2 and their gene frequencies among the major Sudanese tribes (Shaigia-Dinka- Gaalien - Nuba -— Bani-amer), during the period of April 2004 and April 2006. One hundred volunteers from each tribe. Each sample was tested for Kell-1 and Kell-2 by indirect Combs’ test using anti-Kell-1 and Kell-2 antisera. The study group had an age average between ll and 75 years with amean of 28 years. The frequency of Kell-1 was found to be 5.6% while that of Kell-2 was found to be 99.6%. Gene frequencies of Kell-1 and Kell-2 were found to be 0.03 and 0.97 respectively. Percent positivity for the phenotypes K-k+, K+k+ and K+k- were found to be 94.4%, 5.2% and 0.4% respectively. The gene frequencies of K-k+, K+k+ and K+k- phenotypes were found to be 0.941, 0.058 and 0.0009 respectively. All multi-gravida females with history of HDN as well as multi- transfused patients should be reserved for anti-Kell antibodies. All units of blood to be transfused to Kell-1 sensitized patients must be Kell genotyped.
COMPARATIVE STUDYBETWEEN T ROPONIN T AND OTHER CARDIAC AMRICERS ( T ROPONIN I AND CK MB) IN END STAGE HEMODIALYSIS PAT EINT S
(Neelain University, 2007) ABD ALSADE G ABD ALAZEM OSMAN
Abstract The present study aims is to assessment the diagnostic value of cardiac troponin T (cTnT) as a new cardiac marker in patients with chronic renal failure undergoing long term haemodialysis in Sudan using Roche diagnostic ELECSYS 2010 immunoassay compare with other cardiac marker troponin I and CK MB using immulite automated immunoassay and spectrophotometer respectively . Study group of 75 Sudanese patients ( 53 male and 22 female) . patients had and age range (38-80) ( mean age is 59 years ) and 25 healthy subjects was enrolled a control group , blood sample was taken from all patients before starting dialysis . According to assessment of troponin T concentration the study indicate that elevation level of troponin T ( a cutoff cTnT ) >0.l ng /ml are detectable in 28%(n=21) of patients , troponin I cut off (cTnT) 1.0 ngml )detectable in 12 % (n=9) were CK MB (cut off 24.0 u/I) are detectable in 6.7 % (n=5 ) . Diabetics resemble (43%) of patients which have positive troponin T . determination of CtnI and CK MB level can be helpful but these marker hade serious analytical and clinical limitation . This study conﬁrm the troponin T demonstrate improved sensitivity and speciﬁty when compared to the other biochemical marker among haemodialysis patients . The study conﬁrm that the troponin T is an important diagnostic marker that can be used for early detection of myocardial infarction (MI ) among haemodialysis and follow up of patients particularly when such infonnation can not be obtain .
Distribution of Haptoglobin Phenotypes among Sudanese Leukemic Patients
(Neelain University, 2007) Hiba Badr Eldin khalil Ahmed.
Abstract In the present study we aimed to examine haptoglobin phenotypes distribution in Sudanese leukemic patients, and to explore the association between haptoglobin phenotypes and leukemia subtypes. A total of IQ6 Sudanese leukemic patients; 61 males (57.7%) and 45 females (42.5%); age ranging between 1 and 70 years, diagnosed during May 2005 to March 2006, and their 106 match of normal individual were included in this study. Clinical data and Haptoglobin phenotypes for all patients and their matched controls were performed using electrophoresis on polyacrylamide gel followed by benzidine stain. The result were then analyzed statistically for cross tabulation and chi~square tests for leukemia subtypes*sex, leukemia subtypes*age, leukemia subtypes*haptoglobin phenotypes, healthy controls*haptoglobin phenotypes, and tribes distribution*haptog1obin phenotypes. Haptoglobin phenotype analysis revealed common haptoglobin 2-1 phenotype among both, leukemic patients and controls; accounting for 48.2% and 49% respectively. The haptoglobin phenotype analysis showed also distinct ethnic distribution among Sudanese tribes with haptoglobin phenotype 1-1 more common in Afro-Asiatic Sudanese tribes (30.5%), compared with haptoglobin phenotype 2-1 that showed less frequency (26%) in the same tribes. In conclusion the study failed to confirm the previously suggested increased incidence of the Hpl-1 phenotype among leukemic patients since a higher frequency of haptoglobin 2-1 has been observed among patients and the control group.
Isolation and Identification of Clostridium difficile and Other Clostridium Species Associated with Diarrheic Children and Their Susceptibility to Antimicrobial Agents
(Neelain University, 2007) Susan Abdul-laIeef Shareef
Clostridiznn species is part of the intestinal indigenous microbiota of young children and they can produce several endogenous infections Closlridimn difﬁcile frequently colonizes the "human large intestine when the normal colonic flora is disturbed by antibiotic therapy. The result of colonization may be asymptomatic, or it may lead to illness, ranging from mild diarrhea to pseudo-membranous colitis. C. diﬂiqile is a major nosocomial pathogen, responsible for up to 20% of cases of antibiotic- associated diarrhea in industrialized countries, and is an emerging problem in developing countries. The study concerned 552 children, aged l5 days and 8 years. 351 fecal samples were taken from diarrheic children, and (201) were taken from non- diarrheic patient children carrier of C. diﬁicile who were at risk in whom CDAD may develop after using chemotherapeutic agents. Sixty-two isolates of Clostridizun spp. were characterized by colony morphology on several media, spore shape and position, biochemical tests and GLC technique. They identiﬁed as: Closrridium septicum 5 (8.1 %), C. bifermenlans 1 1 (17.7 %), C. sordell/‘i4 (6.45 %), C. pe/fri/1gens5 (8. l %), C. novyi 8 (13 %), C. botulimmz 10 (16 %), C. sporogenes l3 (21 %), C. telani3 (4.8 %) and C. rerliu/n 2 (3.2 %). One strain of C10slria'izun difﬁcile (1.61 %) was detected on selective medium (CCFA). A total of 202 cooked meat carbohydrates selective (CMC+S) broth inoculated with fecal samples, were tested for detection of Closlridium
Molecular Genotyping of Methicillin Resistant Staphylococcus aureus in Khartoum Teaching Hospital
(Al Neelain University, 2007) Eidha Ali Awadh Bin Hameed
This is a cross—sectional study perfomied to detect the methicillin resistant Staphylococcus aureus (MRSA) isolates collected from Khartoum Teaching Hospital in the period from September 2005 to August 2007 by various molecular typing methods. A total of 48 S. aureus isolates were collected ﬁom clinical wound specimens in wards of surgery, orthopaedic, and burns. The number of MRSA was found to be 9 (l8.75%). The isolates were classiﬁed into 3 groups; group 1: S. aureus isolated from the surgical ward (28; 58.3%), group H: S. aureus isolated from the orthopaedic ward (14; 29.2%), and group IH: S. aureus isolated from the bums unit (6; 12.5%). All strains were studied for their susceptibility to commonly used antibiotics. The results revealed that the drug of choice for the treatment of nosocomial MRSA and MSSA is vancomycin. While multi-drug resistance was observed to be common among MRSA strains. Polymerase chain reaction (PCR) was used to amplify the sequence of S. aureus speciﬁc gene at (107 bp) all isolates. Methicillirt resistant (mec/1) gene yielded the amplicon for size at 1319 bp of 9 isolates, and coagulase (coa) gene produced ampliﬁcation products approximately at 500 bp (26/48), and sso bp (22/48). Two distinct PCR-restriction fragment length polymorphism (RFLP) pattems of coagulase gene exhibited among isolates of S. aureus; coaA and coaB. With Alul restriction enzyme digested, the product fragments were approximately at 190, 310 bp and 190, 390 bp with percentages of 54.2% (26/48) and 45.8% (22/48) respectively.
Assessment of Cytological changes in Buccal Mucosa among Al-Qat Chewers
(ALNEELAIN UNIVERSITY, 2007) AmmarSaleh Abdullah Omar
l ABSTRACT This is a case control study; conducted in Hajjah city in Yemen during the period from May 2005-Dec 2007 in order to assess the cytological changes in buccal mucosa among Al-qat users by the use of cytological methods. The study assessed the cytological changes in the buccal mucosa of 300 subjects. Of whom, 150 were Al-qat users (cases), and 150 subjects were non Qat users (controls). Tobacco users were excluded form both cases and controls. Buccal scrapes were taken for preparation of smears and subsequently stained using Pap procedures. Analysis of the cytological smears identified mild cytological atypical changes among 6(4%) of the cases, hence no cytological atypia was detected among controls. Additionally, keratosis was revealed among 24(16%) of the cases and absent among controls. Theses findings indicating that Qat use is a risk factor for oral cytological changes, and this was found to be statistically significant (p<0.005). Of the 67(44.6%) subjects with inflammatory inﬁltrate, 53(35.3%) were cases and 14(9.3%) were controls. Of the 13(8.6%) that showed bacterial infection, 8(5.3%) were detected among cases and 5(3.3%) among controls. Benign degenerative changes among 8(5.3%) of the cases and absent among controls. Al-qat chewing can cause cytological changes in buccal mucosa, this cytological changes increasing with increasing of duration of Qat use. The relation between cytological changes and factors such as age and duration of Al-qat use need further assessment. Oral exfolaitive cytology can be a useful tool for investigation of oral lesions and can be applied for oral screening programs for at risk population. In view of the lack of studies that used cytological methods to assess oral mucosal lesions reported from Yemen, similar studies are recommended.
Estimation of serum uric acid, creatinine, total cholesterol and LDL among Sudanese using Atorvastatin drug
(AL-Neelain University, 2007-05) Ahmed Omer Abuelhassan
Abstract Atorvastatin is lipid lowering drug mainly cholesterol, but it also affect in concentration of other serum parameters such as uric acid and creatinine. Aim: estimation of serum uric acid, creatinine, total cholesterol and LDL among Sudanese using Atorvastatin drug, Method: study was conducted in period between March to May 2017, included 100 participants 60% cases and 40% control with age between (20-70)years. case group included 62% female and 38% male, used different doses (10, 20 and 40 mg/day) and different durations using for variable conditions such as (DM, HTN or protection for risk of CVD). Control group was matched for cases group but not used any lipid lowering drugs. The samples was obtained after used a proper questionnaire and estimated by automated Cobas c311analyzer. Result: significant association between atorvastatin uses and decrease in UA(4.32±0.83), Cr(0.64±0.17), TChl(179.4±45.3) and LDL(115.0±33.8) (P-value: 0.000, 0.020, 0.015 & 0.018 respectively). Decrease in all parameters by increase dose but not significant only significant with dose 40 mg/day (p-value: 0.037, 0.044, 0.044 & 0.005 respectively). Decrease in Cr, TC h and LDL by increase durational use of atorvastatin and concentration of (P= 0.042, 0.001 & 0.000 respectivly). significant association was detected between combination DM & HTN and increase UA(4.55±0.87) & Cr(0.69±0.16) (P-value: 0.032 & 0.015 respectively) without significant association in Chl and LDL (P-value: 0.636 & 0.594 respectively). conclusion, significant decrease in UA, Cr, TChl & LDL mean concentration found among atorvastatin user and the dose 40mg/day is significantly high effect. No correlation between durational used and the parameter concentration. A more researched should be done in this topic to detect specific correlation between this drug and this parameters أتورفاستاتين هو دواء لإنقاص الدهون خصوصا الكوليسترول, لكن له تأثير علي تراكيز مواد أخري بالبلازما مثل حمض اليوريك والكرياتينين. الهدف: تقدير تراكيز حمض اليوريك، والكرياتينين، والكوليسترول الكلي والبروتين قليل الكلسترول (LDL) في السودانيين الذين يستخدمون دواء أتورفاستاتين. أجريت هذه الدراسة التحليلية في الفترة بين مارس إلى مايو 2017، شملت 100 مشارك 60٪ حالات و 40٪ تحكم بمعدل أعمار يتراوح بين (20-70) سنة. وكانت مجموعة الحالات بها 62٪ من الإناث و 38٪ من الذكور الذين يستخدمون جرعات مختلفة من أتورفاستاتين (10 و 20 و 40 ملغ / يوم) لفترات مختلفة (1 إلى 20) سنة. لمختلف الحالات كالـ (السكري، الضغط أو كحماية من امراض القلب). تمت مطابقة مجموعة التحكم بمجموعة الحالات ولكنهم لا تستخدم أتورفاستاتين أو غيرها من الأدوية خفض الدهون. تم الحصول على العينات بعد استخدام الاستبيان المناسب وقياسها بواسطة Cobas c311analyzer الآلي. النتائج: وجود ارتباط واضح بين استخدام أتورفاستاتين وانخفاض في متوسط تراكيز حمض اليوريك، والكرياتينين، والكوليسترول الكلي و LDL (قيمة P: 0.000، 0.020، 0.015 و 0.018 على التوالي). كما وجد اناخفض في حمض اليوريك, الكرياتينين, الكلسترول الكلي و LDL مع زيادة الجرعة ولكن غير واضحة لكن الجرعة 40 ملغ / يوم اظهرت علاقة واضحة في جميع المعاملات ( قيمة P : 0.037، 0.044، 0.044 و 0.005 على التوالي). اظهرت نقصان تراكيز الكرياتينين, والكوليسترول الكلي و LDL بزيادة فتره الاستخدام (قيمة P: 0.042، 0.001 و 0.00 على التوالي) وجد ارتباط واضح بين وجود السكري والضغط معا و زيادة حمض اليوريك والكرياتينبن (قيمة P : 0.032 و 0.015 على التوالي) مع عدم وجود ارتباط لها مع الكلسترول و LDL (قيمة P : 0.636 و 0.594 على التوالي). الخلاصة, انخفاض واضح في متوسط تراكيز المعاملات وجدت بين مستخدمي أتورفاستاتين, الجرعة 40ملغ / يوم هي ذات اثر واضح في تخفيض المعتملات. لا توجد علاقة ارتباطية بين فترة المستخدم و تركيز المعاملات. لذلك نوصي بإجراء المزيد من البحوث في هذا الموضوع للكشف عن ارتباطات بين هذا الدواء وهذه المعاملات.