Al Neelain Medical Journal - VOL - 17
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Item The clinical importance of anti-CCP in early diagnosis of Sudanese patients with rheumatoid arthritis(جامعة النيلين - مركز النيلين الطبي, 2015-11) Ahmed BoladAbstract Background: Rheumatoid Arthritis (RA) is a systemic inflammatory autoimmune disorder; it is the most common inflammatory arthritis in the world. The early diagnosis and effective treatment of rheumatoid arthritis (RA) can improve the clinical outcome of the disease. Recently, anti-Cyclic- Citrullinated protein antibodies (Anti-CCP) are found to be more specific to RA arthritis although in the early stages when the arthritis is undifferentiated. The objective of this study was to determine the clinical importance and the prevalence of anti-CCP in early diagnosis of Sudanese patients with RA. Methodology This work was a cross-sectional study conducted at Al Ribat teaching hospital (from June 2012 to ? 2014). The study sample included 56 Sudanese patients, known patients of RA who fulfilled the ACR criteria. Demographic and clinical data were collected by questionnaires. All patients and controls sera were investigated for anti-CPP by enzyme linked immunosorbent assay (ELISA). Results The mean age of RA patients in this study was 46.0 (±11.7) years. The control group consisted of 56 Sudanese apparently healthy subjects, 27 (48%) of them were female with mean age of 37 ±17.2years. The anti-CCP antibodies were detected in 60.7% of cases, and in two (3.6%) of the control group. The sensitivity of anti-CCP was 60.7% and specificity of 96.4%. Anti-CCP test has a maximum proportionate reduction in uncertainty (PRU) of 94% for a positive result and 59% for a negative result. Conclusions Anti-CCP antibody has a higher diagnostic specificity and positive predictive value than rheumatoid factor; however its sensitivity was low. The consent of each patient was obtained prior to commencement of data collection.Item The Proximate Fertility Determinants among Sudanese Women in an urban community, Case study of El Dueim town(جامعة النيلين - مركز النيلين الطبي, 2015-11) Asia Mohamed Sharifمستخلص عض هذه ة محاولة لتقصي " اني في السودان، والد ا رسة الحال التغیر الس العوامل المسئولة عن نم ة إحد تعتبر الخصو د ا رسة حالة. استخدمت الد ا رسة م " ة في السودان، آخذین مدینة الدو & الحضر ( ة في المناط العوامل التي تؤثر على الخصو م الحمل، وفترة " الزواج، وسائل تنظ إطار تحلیلي.اختارت الد ا رسة نم طة " ة الوس نموذج "بنغارت" لمحددات الخصو اشرة. صورة م ة طة تؤثر على الخصو " محددات وس لهن توقف الحمل، لتحلیلها ( ار عینة من نساء سب " تم اخت اعتماد ة " ق قة الط & الط ر اً " ار العینة عشوائ " م. جاء اخت " ٤٩ سنة)، وذلك من ٢٨ حي في مدینة الدو - الزواج( ١٥ احثة لهذا الغرض. استمارة صممتها ال (& انات عن طر " إطار للعینة. وجُمعت الب م " تقدی ا رت تعداد ١٩٩٣ لمدینة الدو ة ن ذات أثر معتبر على محددات الخصو الس م، العمل، ونم " أهم النتائج التي توصلت الیها الد ا رسة هي: إن التعل النساء المتعلمات والملتحقات م الحمل أكثر انتشا ا رً وس " طة، وجدت الد ا رسة أن معرفة واستخدام وسائل تنظ " الوس ة، فترة توقف الحمل بین الولادات تطول " وم المدینة والمساكن الح اء وس " ن في أح س" عمل مدفوع الأجر، والائي عة. وتعتبر اطالة فترة اء الدرجة ال ا ر " نَ في أح س" غیر المتعلمات، وغیر الممتهنات لعمل مدفوع الأجر، ومن وس هذه المجموعة. أما في المجموعة الأولى، فیتعبر الاستخدام ة لتأخیر الحمل وس " س" توقف الحمل هي الوسیلة الرئ ض للفترة القصیرة لتوقف الحمل لد " ة لتأخیر الحمل وهي تعتبر تعو " س" م الحمل هي الوسیلة الرئ " الفعال لوسائل تنظ هذه المجموعة. ABSTRACT Fertility is one of the factors responsible for the pattern of population change that is believed to be taking place in Sudan, this study is an attempt to investigate some factors affecting fertility in a Sudanese urban setting, taking El Dueim town as a case study. Bongaarts,s model for the" proximate determinants of fertility" is used as the analytical framework . Marriage pattern, contraception and post-partum infecundity are analyzed as the main proximate determinants that affect fertility directly. A sample of ever –married women aged 15-49 years was selected from the 28 neighborhoods in El Duim town. The sample was selected randomly using stratified cluster sampling procedure. The1993’s census’ projection of El Dueim town formed the sampling frame. The data was collected by face to face interview NMJ Nov. 2015 vol.3 No.17 ISSN 1858-6155 56 NMJ 2015 using a designed questionnaire. Education, occupation and type of residence have a considerable effect on the proximate determinants of fertility. Ever-use, knowledge and current use of contraceptives are found to be more common among the women who are educated, engaged in gainful jobs and reside in the town centre & government houses; post-partum infecundity periods are longer among the uneducated, unemployed and those who reside in fourth class neighborhood. The long period of infecundity is considered as the main mean to delay birth among this group. The effective use of contraceptive is the main mean to delay birth, which compensate the short period of post-partum infecundity among the former group.Item Uterine fibroid and pregnancy outcomes in Khartoum Teaching Hospital, Sudan(جامعة النيلين - مركز النيلين الطبي, 2015-11) Moawia E Hummeida, Moawia Al; Ali Mohamed Ali, Abdel Azim AliAbstract Objectives: To investigate the effect of uterine fibroids on pregnancy outcomes. Methods: This case-control study was conducted in the Khartoum Hospital, Sudan, during June 2011 and through May 2012. Cases were pregnant women who have uterine fibroids, diagnosed by ultrasound scan or discovered accidentally during caesarean section. One consecutive pregnant woman who have no uterine fibroids per case acted as control. We included all pregnant women who attended the labour ward, or planned for either normal or operative delivery, in the hospital, during the study period, and accepted to participate in the study. Results: Using logistic regression analyses there was significant association between: delayed to conceive (CI= 2.9 – 11.1, OR= 5.7, P= <0.001), miscarriage (CI= 3.7 – 18, OR= 26.4, P= 0.001), experience of pain during pregnancy necessitating hospital admission (CI= 4.1 – 25.7, OR= 10.3, P= <0.001), antepartum haemorrhage (CI= 0.01 – 0.5, OR= 0.07, P= 0.010), uterine atony (CI= 0.02 – 0.56, OR= 0.1, P= 0.008), need for blood transfusion as a result of uterine atony (CI= 0.8 –6.5, OR= 2.2, P= 0.032), and uterine fibroids in pregnancy, compared to women without uterine fibroids. Pregnancy with uterine fibroids also had a higher unplanned caesarean section rate (CI= 0.1 –0.8, OR= 0.3, P= 0.014), but there was no differences in perinatal outcomes (Delivery at term, living births, birth weight, and preterm birth. between the two groups of the study. Conclusion: Uterine fibroids increase the risk of adverse obstetrics outcomes during pregnancy and childbirth in a varying ways. This information can be used to aid counselling and riskstratifying patients. المستخلص الورم الليفي في الرحم و نتائج الحمل في مستشفى الخرطوم التعليمي ,السودان الأهداف: للتحقيق في تأثيراللحميه الرحمية على نتائج الحمل في مستشفى الخرطوم التعليمي. الأدوات والطرق: أجريت هذه الدراسة الإفرادية في "مستشفى الخرطوم، السودان"، خلال يونيو ٢٠١١ ، ومن خلال أيار/مايو ٢٠١٢ .شمل البحث النساء الحوامل الذين لديهم لحميات شخصت بالموجات الصوتيه او اثناء القيصريه. امرأة حامل واحدة على التوالي بدون لحميه تم تضمينها بمثابة عنصر التحكم . قمنا بتضمين جميع النساء الحوامل اللاتي حضرن جناح المخاض، أو خطط لهم للولادة الطبيعيه في المستشفى، خلال فترة الدراسة، وقبلن المشاركة في الدراسة- أو = ٥.٧ ، ف = ،CI = 2.9 – النتائج: باستخدام تحليل الانحدار اللوجستي كان هناك ارتباط كبير بين تأخير الحمل ( 11.1 الشعور بالألم أثناء الحمل الذي يستلزم دخول ،(P = 0.001 ، أو = ٢٦.٤ ،CI = 3.7 – ٠.٠٠١ )، الإجهاض ( 18 > P = ، أو = ٠.٠٧ ،CI = 0.01 – أو = ١٠.٣ ، ف = < ٠.٠٠١ )، النزف قبل الولادة ( 0.5 ،CI = 4.1- المستشفى ( 25.7 CI = 008 )، الحوجه لنقل الدم نتيجة وني الرحم (– 0.8 ،P = 0 ,١ , أو = ٠ ،CI = 0.02 – 0.010 )، وني الرحم ( 0.56 P = ، أو = ٠.٣ ،CI = 0.1 – تلاحظ ارتفاع معدل القيصرية غير المخطط لها ( 0.8 ،(P = 0.032 ، 6.5 ، أو = ٢.٢ 0.014 ) ولكن لم تكن هناك أية اختلافات في نتائج الفترة المحيطة بالولادة (الولادات الحية، الخداج الولادة.. إلخ)، بين هاتين المجموعتين من الدراسة. الاستنتاج : اللحميه الرحمية تزيد من خطر النتائج السلبية للتوليد أثناء الحمل والولادة بطرق مختلفة- يمكن استخدام هذه المعلومات للمساعده في اسداء المشوره وتفاوت المخاطر للمرضىItem Molecular Markers Assessment of Chloroquine Resistance to Plasmodium falciparum Isolates in Wad Medani District, Gezira State, Sudan(جامعة النيلين - مركز النيلين الطبي, 2015-11) Osman K. Saeed, Henk SchalligAbstract: Background: Molecular surveillance of antimalarials resistance is of significant importance for the endemic countries, the introduction of polymerase chain reaction (PCR) into malaria research becomes an essential tool to investigate several genetic mutations to predict or monitor antimalarial drugs resistance . Method: In Wad Medani district central Sudan, 51 blood isolates were collected in filter paper from individuals infected with P. falciparum, DNA was extracted from each sample and then subjected to molecular analysis for chloroquine transporter (pfcrt) and multi-drugs resistance1 (Pfmdr1), using the polymerase chain reaction - restriction fragment length polymorphism ( PCR-RFLP ) method. Result: The results showed that 30/40 (75%) were pfcrt at codon 76 mutant and 10/40(25%) were wild type while the results of pfmdr1 at codon 86 demonstrated that 22/37(59.5%) were mutant and 15/37(40.5%) wild type, both mutations were abundant in 19 of the isolates while each mutaion alone was abundant in 11 and 3 for pfcrt and pfmdr1 respectively, indicating that the frequency of CQ resistant mutations was 33/40(82.5%). Conclusion; This study concluded that the mutations in pfcrt and pfmdr genes were abundant with high frequency among the P. falciparum populationItem In Vitro Callus Induction and Antimicrobial Activities of Callus and Seeds Extracts of Nigella sativa L.(جامعة النيلين - مركز النيلين الطبي, 2015-11) Mawahib E.M. ElNour, Futooh Z. A. MahmoodAbstract: In this study, extracts of Nigella sativa seeds and its induced callus were investigated for their antimicrobial activities against four standard bacteria (Bacillus subtilus , Staphylococcus aureus , Escherichia coli and Pseudomonas aeruginosa) and two fungi (Candida albicans and Aspergillus niger) by using agar diffusion method. To induce callus, hypocotyls and cotyledons explants from N. sativa were cultured in MS medium supplemented with different types and different concentrations of growth regulators. Explants of N. sativa showed a rapid rate of initiation of callus after two weeks when grown in MS media supplemented with NAA at 1.0 mg/l and 5.0 mg/l of NAA respectively, while a slow rate of induction of callus observed when the hypocotyls grown in MS media supplemented with 5.0 mg/l 2,4-D and 0.5 mg/l 2,4-D, when the explants were cotyledons. The NAA in this study was found to be the suitable hormone regulator for N. sativa for both types of explants used. Methanolic extracts of seeds and callus of N. sativa showed activity against Escherichia coli with inhibition zone (21mm)&(23mm) respectively and no antifungal activity was observed for both seeds and callus extracts. The antibacterial activity of Penicillin and Gentamicin were determined against the tested bacteria and compared with the antibacterial activity of the tested extracts of N. sativa seeds and callus. Methanolic extracts show antimicrobial activity against E. coli higher than that of Gentamicin and Penicillin at 10μg/disc. Phytochemical screening for the seeds and callus extracts indicated the presence of secondary metabolites such as alkaloids, flavonoids and tannins which may be responsible for the antimicrobial activity of the tested extracts.Item Uterine fibroid and pregnancy outcomes in Khartoum Teaching Hospital, Sudan(مركز النيلين الطبي, 2015) Moawia E Hummeida1; Moawia Ali2, Ali Mohamed; Ali Mohamed Ali3; Abdel Azim Ali4Uterine fibroids increase the risk of adverse obstetrics outcomes during pregnancy and childbirth in a varying ways. This information can be used to aid counselling and risk-stratifying patients.Item The Proximate Fertility Determinants among Sudanese Women in an urban community, Case study of El Dueim town(2015) Asia Mohamed SharifFertility is one of the factors responsible for the pattern of population change that is believed to be taking place in Sudan, this study is an attempt to investigate some factors affecting fertility in a Sudanese urban setting, taking El Dueim town as a case study. Bongaarts,s model for the" proximate determinants of fertility" is used as the analytical framework . Marriage pattern, contraception and post-partum infecundity are analyzed as the main proximate determinants that affect fertility directly. A sample of ever –married women aged 15-49 years was selected from the 28 neighborhoods in El Duim town. The sample was selected randomly using stratified cluster sampling procedure. The1993’s census’ projection of El Dueim town formed the sampling frame. The data was collected by face to face interview using a designed questionnaire. Education, occupation and type of residence have a considerable effect on the proximate determinants of fertility. Ever-use, knowledge and current use of contraceptives are found to be more common among the women who are educated, engaged in gainful jobs and reside in the town centre & government houses; post-partum infecundity periods are longer among the uneducated, unemployed and those who reside in fourth class neighborhood. The long period of infecundity is considered as the main mean to delay birth among this group.Item Molecular Markers Assessment of Chloroquine Resistance to Plasmodium falciparum Isolates in Wad Medani District, Gezira State, Sudan(مركز النيلين الطبي, 2015) Bakri Y. M. Nour1, 2; Ahmed A. Mohamadani2, 4; Osman K. Saeed1, 3; Henk Schallig4.Molecular surveillance of antimalarials resistance is of significant importance for the endemic countries, the introduction of polymerase chain reaction (PCR) into malaria research becomes an essential tool to investigate several genetic mutations to predict or monitor antimalarial drugs resistance .Item In Vitro Callus Induction and Antimicrobial Activities of Callus and Seeds Extracts of Nigella sativa(مركز النيلين الطبي, 2015) Mawahib E.M. ElNour1; Futooh Z. A. Mahmood1