Household Air Pollution

Household air pollution from the use of biomass fuels is a major public health hazard affecting over 3 billion people living in developing countries most of whom are women and children. In Sudan the national burden of disease attributed to biomass fuel use is estimated to be 0.7% but may be significantly higher as this is an estimate based on estimates of exposure. Biomass fuel combustion releases many toxic pollutants which are damaging to the respiratory tract, the cardiovascular and neurologic systems and are associated with low birth weight and fetal wastage. Household air pollution has been studied primarily by using devices which measure exposure in dwellings and on the clothes of the residents. These devices measure the most important pollutants, carbon monoxide, sulfur dioxide, and particulate matter. Although inhaled sulfur dioxide and particulate matter damage the lungs, only carbon monoxide is systemically absorbed and only carbon monoxide can be measured in the body. In this paper, we will review the pathophysiology of carbon monoxide poisoning and report some preliminary results of the study which we, Prof. Suliman and our colleagues from Sudan carried out immediately prior to this conference

Stem Cells in Dental Tissues and Their Regenerative Potential

Stem cells provide an attractive novel therapeutic approach for repair and replacement of pathologically damaged tissues. Adult stem cells are becoming largely recognised as potential source of stem cells for future therapy given the controversy around embryonic stem cells. Dental tissues are readily available source of adult stem cells following teeth extraction. Within teeth Stem cells reside in the dental pulp, the periodontal ligament and the apical papilla. These cells are multipotent stem cells of mesenchymal origin that can be successfully differentiated into various specialised cells. Using explants culture and magentic beads separation methods we isolated stem cells form dental pulp and periodontal ligament. We developed a protocol for in-vitro differentiation of dental pulp stem cells into functional neurons and odontobalsts. The osteogenic potential of periodontal ligament stem cells is also explored in addition to the effect of inflammation on renewal and regenerative capacity of these cells. We are particularly interested in the factors that determine fate and terminal differentiation of stem cells to help develop mechanisms for directed differentiation of stem cells for future tissue engineering and regenerative medicine

Using immunostains to distinguish the look-alike Blue Cell Tumors, their pathogenesis and behavior: Experience of a single center in Khartoum

Blue cell tumours are a diverse group that look alike in the H&E stained sections and are difficult to distinguish from each other except by immunohistochemistry. They include: Desmoplastic small-round-cell tumour, Ewing's Sarcoma/PNET, Neuroblastoma, Medulloblastoma, Rhabdomyosarcoma, Carcinoid tumor, Small cell lung cancer, Wilms' tumour, Retinoblastoma, Small-cell lymphoma and Hepatoblastoma. We have encountered all these in our practice. Because of the long list only some will be discussed. These are Ewing group of tumours and some uncommon but quite interesting members of the other Blue cell tumours. There are 3 main types of Ewing tumors: Ewing sarcoma of bone, Extraosseous Ewing tumor (EOT) and Peripheral primitive neuroectodermal tumor (PPNET). The latter is a rare childhood cancer that involves the brain and can also starts in the bone or soft tissue and shares many features with Ewing sarcoma of bone and EOT. Peripheral PNETs that start in the chest wall are known as Atkin tumors. We used certain immunohistochemical stains to correctly diagnosis these cases. Classic Ewing sarcoma is positive for CD99, Vimentin but negative for the neural stain S-100 protein. PPNET has the same markers as Ewing but they are s-100 and Cytokeratin and/or EMA positive. We had odd sites for Ewing sarcoma such as the Esophagus. Some other interesting small round cell tumours are myelomas. When they have typical appearance of plasma cells the diagnosis is easy. However there is a poorly differentiated plasmacytoma that looked like other blue cell tumours. One was in the spine. It stained positive for the B cell marker CD20 but was negative for LCA which led us to do immunostaining for plasma proteins. The cells were positive for IgG and negative for Ig A and Ig M. Mature plasma cells of multiple myeloma are negative for CD20. Diagnosis: Myeloma of the small lymphocyte-like type involving D11

Management of Epilepsy for Nurses

Epilepsy is most common and serious chronic neurological disorder. It is treatable and compatible with normal life but surrounded by significant stigma and lack of training for health care staff and the public. Nurses take on most of the care in rural areas and they need to be equipped with knowledge and skill to deliver safe care

The Social Accountability of Medical Schools; not just a passing phase

The concept of Social Accountability is not new, having been first defined by the World Health Organization twenty years ago. The last ten years however have seen it grow in importance, being built into many accreditation procedures and respected as an integral part of curriculum development in a substantial number of medical schools, worldwide. Despite this growth, the concept is still not fully understood by many, who see it purely as an extension to community-based and community-orientated education. The purpose of this session will be to explore the concept of social accountability, what it means for the institution and individuals involved and how it can be implemented in a correct and purposeful manner

Writing a successful grant proposal

In this interactive session, Prof. Melanie Newport and Prof. Gail Davey will demystify the grant application process. Using examples from a range of successful applications, they will cover identification of appropriate calls, translation of an idea into a research question, developing a methodology, drafting a budget and ‘grantsmanship’. Participants are encouraged to bring their ‘in process’ applications as material to work on. Newport and Davey have served on review panels and grant-making committees of the Wellcome Trust, the UK Medical Research Council and the Royal Society of Tropical Medicine & Hygiene. They have written scores of applications between them, and have supervised Masters and PhD students to successful application

Molecular and Immunological Characterization of Malaria (Plasmodium falciparum) in Central Sudan

تتواجدالملاريا في أكثر من مائة بلدا واقليما. كما ان أكثر من 40 ٪ من سكان العالم عرضة لخطر الإصابة بمرض الملاريا. ا الملاريا الخبييثة من نوع فالسبرم هى من اكثر أسباب حلات الاصابة و الوفيات ، ومن بين 300 و 500 مليون حالة جديدة من حالات الملاريا تحدث في كل عام نتجة للملايا الخبية 1- 3000000حالة وفاة ،و معظمهم من الأطفال الأفارقة دون سن الخامسة. الأفراد الذين يعيشون في المناطق التى تتوطن بها الملاريا يمكن تقسيم حالات الاصابة لديهم حسب الاعراض المرضية، ملاريا غير عرضية وملاريا عرضية وقسمت العرضية الى ملاريا خفيفة وملاريا خبيية وهذه التغيرات في نمط المرض تعزى إلى عدد من العوامل المختلفة ، سواء البيئية والوراثية . الهدف الاساسى من هذه الدراسة تحديد ما اذا كانت التحكم الجينى له دورا مؤثر فى ظهور الاعراض المرضية، الاستجابة المناعية ومستوي تواجد الطفيل في الدم في مرضى الملاريا الخبيثة من نوع فالسبرم باستخدام جينات انترليوكين -4 كدلالة لذل

Nasopharyngeal cancer in Sudan: Clinical, Epidemiological, Histology and Molecular Characteristics

Nasopharyngeal cancer is a common cancer among Sudanese; it is the fifth among men and the ninth among women. Objectives: To study the epidemiology, clinical features, staging, etiology and pathology of nasopharyngeal cancer in Sudan. Study design: This is a prospective study. Setting: ENT Khartoum Teaching Hospital, Khartoum City, Sudan. Subjects and methods: Patients suspected to have nasopharyngeal cancer were assessed during the period Mar 2006 to Dec 2008. Data from Confirmed cases was obtained; it included clinical and epidemiological information. Results: One hundred and fifty five cases were studied. Bimodal age distribution of the disease was noted with two peaks, one at 15-19 years and one at 50-54 years. The male to female ratio was 2.6:1 and a distinct geographical distribution of the disease was noted, with clustering of cases in the towns of Dilling, Kadogli and the surrounding rural area of the Nuba Mountains, these areas in the Western States, were reported to be of high background radiation due to naturally produced radioactive uranium. Nuba tribe headed the list among other tribes. Seventy percent of cases presented at stage IV. There was predominance of type II (27.7%) and type III (62.5%). Patients were treated by neoadjuvant chemoradiotherapy. Of the 62 fresh nasopharyngeal specimens that are studied for the presence of EBV by Polymerase Chain Reaction (PCR), 87.1% and 83.8 % were positive using LMP-1 and NA-1 as primers. Conclusions: Nasopharyngeal cancer is an important form of cancer in Sudan. Some tribes are significantly more affected than others. Patients present with advanced disease. EBV is present in the majority of studied fresh specimens. Environmental and genetic factors need further studies. Screening at risk populations that aim at early diagnosis and management of patients is recommended. Key words: Nasopharyngeal cancer, Sudan, epidemiology, clinical staging, pathology, etiology

Herbal Products Development Workshop

The workshop is essentially dealing with two aspects related to herbal medicine but they differ significantly in the approach and methodology involved in the process of drug discovery and development. These approaches, however, will either lead to the development of a standardised phytotherapeutical products based on the totality of the chemical ingredients present in a plant (i.e. herbal product) or the isolation of a single bioactive natural product of a herbal origin which will be subjected to long process of drug discovery and development entailing a substantial time, cost and advanced technology

Effect of different levels of salinity on growth, yield and seed quality of barley (Hordeum vulgare)

2003Two pot experiments and laboratory tests were conducted during two seasons (1999/2000 and 2000/2001) to investigate the effect of different levels of salinity on barley seed yield and seed quality. The two pot experiments were carried out at Shambat, Faculty of Agriculture University of Khartoum while the laboratory tests were carried at the Seed Administration Lab, Federal Ministry of Agriculture and Forestry, Khartoum. Local barley cultivar was used in 1999/2000, while in 2000/2001 four introduced cultivars were used along with the local cultivar. Seeds were planted at 5 levels of soil salinity in 1999/2000 (0, 2, 4, 6 and 8 mmohs/cm) and 4 levels (0, 4,6 and 8 mmohs/cm) in 2000/2001. The results revealed significant effect of salinity on seedling emergence, all growth and yield parameters and seed quality. Salinity increased seedling emergence percentage and reduced days to 50% heading. Significant increase in number of spikelets/spike, number of seeds/spike and seed yield/pot was found in the first season. No significant effect was obtained on number of tillers / plant, number of spike/plant and 100 seed weight. In the second season significant increase in number of tillers/plant, number of spikes/plant and 100 seed weight was obtained in response to salinity. Significant reduction was found in number of spikelets/spike, number of seeds/spike and seed yield/pot. Seed quality evaluations revealed that salinity resulted in an increase in seedling shoot and root lengths but reduced seedling growth rate, seedling dry weight and speed of germination in the first season. No significant effect was found on standard germination percentage. In the second season, standard germination percentage, seedling shoot length and speed of germination were increased by salinity. Seedling root length was reduced by salinity and no significant effect was found on seedling dry weight and growth rate. Salinity level of 6 mmohs/cm resulted in a significant increase in growth and yield parameters as well as seed quality. The local cultivar was found to be more tolerant to salinity than the introduced cultivars as reflected in growth parameters and seed quality. The interaction effects between salinity levels and cultivars were significant in some tests of growth, yield and quality parametersUOF