Rapidly Progressive IgA Nephropathy in One of a Pair of Identical Twins

Introduction: IgA nephropathy (IgAN) is the most common cause of primary glomerulonephritis worldwide. It was considered a benign condition for many years but long term follow up showed that it might progress to end stage renal disease (ESRD). The cause of primary IgAN is unknown and no consistent genetic abnormalities that predict the development or progression of IgAN have been identified. A variety of observations suggest an as-sociation to an unknown environmental antigen, familial clustering, or infectious agent. The patient presented here is the first report of a child with IgAN in Sudan. Case report: a seven years old boy was referred to our center for further evaluation and management of sudden onset macroscopic hematuria and renal impairment. He was born after an uneventful pregnancy and breast fed. He developed normally and was healthy before this illness. He had eight siblings who were all healthy, including his identical twin brother. Physical examination and laboratory tests led to the diagnosis of IgAN. The patient was treated with peritoneal dialysis and pulses of methylprednisolone for three consecutive days. He showed a remarkable response and regained normal renal function. He was then kept on alternate day’s steroids, ACE inhibitors, and Azathioprine. The other twin is being closely monitored. Conclusion: This report provides an indirect support for the hypothesis that environmental factors play a role in the pathogenesis of IgAN. However, follow up of the currently healthy twin is necessary, since affection with the disease may be expressed at a later time. Key words: IgA nephropathy, identical twins, macroscopic hematuri

Antimicrobial Activity and Some Physiochemical Properties of Pumpkin (Cucurbita pepo L.) Seed oil

Pumpkin and squash plants grow in warm, humid regions,  cannot withstand frost. Most of the pumpkin consumed in Sudan was grown in Kordufan (western sudan).The use of plants and their extracts as remedies for curing many diseases have stimulate studies for investigating the presence of effective antimicrobial substances in them The present study was investigating the physiochemical and the biological activity of the different solvent extracts of pumpkin (Cucurbita pepo) seed oil (hexane, ethanol, methanol, and water) against two fungi  (A. niger and P. italicum) and two bacteria (E.coli and Staph. aureus).The inhibition zone method  was used for bacterial tests and the mycelia weight method was used for the fungal study. The results of the physiochemical showed that the specific gravity of the oil was between 0.997–0.908. The Refractive index was between 1.46–1.470. The average iodine value was 117.97,  the free fatty acids was between 0.2 and 0.55. The peroxide value was in the normal range (5.92–9 and the average saponification value was about 188. The biological study showed that the fresh and the dry weights of mycelia were highly reduced, although the reduction was only statistically different at the higher concentrations (75-100%).The fresh weights for the higher concentrations were 1.65 and 1.0 and for the lower concentrations were 3.1 and 3.7 for both A. niger and P. italicum, respectively. The inhibition zone of growth of both bacteria was far greater than that of the control treatment. The results indicated that the pumpkin oil extracts are more effective against bacteria compared to fungi. The hexane extract  was giving a large  inhibition zone (about 26.5 mm diameter) while, the ethanol extract was giving a less inhibition zone (about 14.2.mm diameter). On the other hand both methanol and the aqueous extracts were giving very low inhibition zones (13.5 and 13.6 mm diameter, respectively). However, more physiochemical characterizations need to be done  and the antifungal and the antibacterial properties  should verified in any further  studies on the pumpkin seed oil

Impact of the underlying cause and co-morbid conditions on the outcome of hepatic encephalopathy

Background: Hepatic encephalopathy (HE) is a serious neuropsychiatric complication of acute and chronic liver diseases. This study aimed at identifying liver diseases and co-morbidity conditions associated with hepatic encephalopathy (HE) and their impact on patient`s mortality (the outcome).Methods: A hospital-based, prospective study enrolled 76 patients admitted with HE conducted at Ibn Sina specialized gastroenterology hospital, Sudan, from January 2010 to May 2011. Personal data, clinical presentation, underlying liver disease, precipitants, co-morbid conditions and the outcome of HE were obtained from the inpatients’ hospital records.Results: A total of 76 patients were included, 62 males (81.5%) and 14 females (18.5%) aged between 13 and 84 years old. Hepatitis B virus (HBV) was the most common cause of the liver disease (36.8%), followed by HCV (11.8%). Clinically, 53 patients (69%) had impaired level of consciousness. Infection was the most common risk factor for HE (54%) followed by electrolyte disturbance (42%). Overall mortality within one to three weeks following the admission was (50%). The higher percentage of mortality was seen inpatients with late stage autoimmune hepatitis, followed by HCC and in co-morbid conditions like renal impairment (58.8%).Conclusion: HE is associated with a high mortality despite proper management in specialized hospitals. The mortality tends to increase in the presence of comorbid condition.

Properties of High-Performance Concretes made of Black Sand at High Temperature

To modify high-performance concrete (HPC) fireproofing properties, black sand (BS) was partially substituted as fine aggregate at various levels. This study aims at evaluating the BS reliability in improving HPC durability properties for various construction applications based on its unique heavy minerals. To achieve this, five HPC series blends were setup to substitute fine aggregate independently with BS. Substitution percentages ranged from 15 to 100% with consistent supplementary cementing materials (SCMs) proportion for each gathering. Tests were performed to assess compressive strength before and after fire exposure under various temperatures of 250, 500 and 750 °C at different curing age. Generally, blending FA with BS was better than using SF with BS. Utilizing BS in the range of 15 to 60% as fine aggregate with 10% FA improves HPC fire-insulating properties. Besides, Z1 SEM analysis observed homogenously and compacted HPC microstructure at 250 and 500 °C. Doi: 10.28991/cej-2021-03091634 Full Text: PD

The Association between Prolonged Occupational Exposure to Paraphenylenediamine (Hair-dye) and Renal Impairment

Introduction: Paraphenylenediamine (PPD) is widely used in hair dyes and cosmetic skin application. PPD intoxication following oral ingestion could be an important cause of ARF in Sudan, Morocco and the Indian Subcontinent. Repeated and prolonged exposure to PPD may also be associated with Chronic Kidney Disease (CKD). Methods: This is a cross-sectional study that covered six conveniently-chosen hairdressing saloons in Khartoum, Sudan. Hairdressers with regular professional exposure to PPD were evaluated for the presence of renal impairment (serum creatinine ≥ 2 mg/dl) and other markers of kidney damage. Results: The study included seventy-two females with a mean age of 40±8 years and a median duration of exposure to PPD of 6 years. Renal impairment, proteinuria and hematuria were observed in 14%, 26.4% and 41.1% of hair dressers, respectively. Hypertension, skin changes and bronchospasm were found in 19.4%, 38.9% and 22% of participants, respectively. Using pure forms of PPD significantly increased the risk of having elevated serum creatinine (OR 5.9; P = 0.02) and proteinuria (OR 9.8; P = 0.002) compared to manufactured forms with lower concentrations. Each additional year of exposure to PPD significantly increased the risk of having elevated serum creatinine (OR 1.3; P = 0.01), proteinuria (OR 1.4; P = 0.001) and hematuria (OR 1.1; P = 0.04). Conclusion: In this group of hairdressers with regular exposure to PPD, we observed high prevalence of renal impairment, proteinuria and hematuria. These findings were significantly associated with the use of pure forms of PPD and longer duration of exposure. Keywords: Chronic Kidney Disease; Hair Dye; Occupational Hazard; Paraphenylenediamine; Nephrotoxicit

Childhood Steroid Sensitive Nephrotic Syndrome: Characteristics and Predictors of Relapses; A study at a Single Center in Khartoum

Background: Childhood steroid-sensitive nephrotic syndrome (SSNS) usually has a favorable outcome in spite of its relapsing course. The objective of the authors was to study the demographic and clinical characteristics, outcome and risk factors for relapses in children with SSNS at a single center in Khartoum, Sudan. Material and Methods: In this cross-sectional, facility-based study, the authors retrospectively reviewed all the records of children with SSNS, followed at the Pediatric Renal Unit, Soba University Hospital, Khartoum between 2001 and 2014. SSRNS was defined as the remission of proteinuria within 4–6 weeks of corticosteroids. Relapse is therecurrence of proteinuria after remission; frequent if ≥ 2 within initial six months or ≥ 4 within one year, and steroid dependence if 2 during therapy or within 14 days after stopping it. Results: 330 children (males 220; 66.7%) with SSNS were studied with a mean age of 5.2 ± 3.5 years of whom 42.4% aged 1–5 years. At the presentation, hypertension was detected in 31.8% and hematuria in 19.1%. Serum cholesterol was elevated in all patients (mean 347.34 ± 117.87 mg/dl) and serum creatinine in 7.27% (mean 1.4 ± 0.35 mg/dl). Renal histology showed mesangioproliferative glomerulonephritis (MesPGN) in 57.5%, minimal change disease (MCD) in 35.5%, and focal segmental glomerulosclerosis (FSGS) and IgM nephropathy in 3.5% each. During the course of the illness, 10.3% achieved long-term remission, 89.7% relapsed— of whom 52.3% had frequent relapsing/steroid-dependent (FR/SD) course and 37.7% had infrequent relapses. Risk of frequent relapses were age of onset and low/moderate socioeconomic status (P = 0.015 and 0.019, respectively). Infectionswere recorded in 71.8%, but not significantly associated with the risk of frequent relapses (P > 0.05). Conclusions: The majority children with SSNS at this single center in Khartoum had a relapsing course with the majority being FR or SD. Predictors of frequent relapses were young age at onset and low socioeconomic status

A Saas-Based Approach in an E-Learning System

In the United States schools in the K12 School System, that provide education for primary, junior and senior high school students, are moving toward information systems to solve and automate some manual processes performed in these schools. With this movement, and the pressure on schools to use technology to improve student achievement, many schools are turning to learning management systems as a way to enhance student learning. Recent surveys show that K-12 online learning is a rapidly growing phenomenon. Also, many states in the United States, including Michigan, require an online experience for all graduates. Due to the rapid growth of cloud computing and Platform-as-a-Service (PaaS) there has been a shift towards web applications in some E-Business systems. Another shift is in the way software is being delivered to the end-user, namely using the Software-as-a-Service (SaaS) model. System integration is part of the huge challenge facing K12 schools in small and large school districts. Not having an integrated system is causing schools many tribulations, such as inconsistent data, duplicate manual data entry, and extra time needed to manage user accounts, and non-productive time spent on technical support. In addition, the task of maintaining the individual systems is time consuming. Despite the potential advantages, these systems can bring challenges to schools’ existing architecture. This research paper focuses on a comprehensive and innovative solution based on a conceptual framework and utilizing Web 2.0 technologies. The aim with the research project was to design a conceptual architecture for next generation of education system (E-Education 2.0), based on open source and Web 2.0 technologies, and utilizing cloud computing. This proposed solution has involved an analysis of all the business and information technology systems in the K12 environment. The solution also addresses the concerns of stakeholders by utilizing an integrated enterprise architecture, and when implemented would result in a cost effective, adaptable and scalable E-learning System. Teachers will be able to integrate information technology based features into the curriculum. Furthermore, the proposed solution provides a clear roadmap of how to transition existing individual systems into one integrated system, based on SaaS and PaaS technologies. The introduction of E-learning management systems into the mainstream K12 schools is expected to solve some of the problems in this education sector, but poses challenges such as systems integration of existing architectures. While SaaS has been widely used and adopted in several countries, there are still barriers to entry in developing countries

TMSA: participatory sensing based on mobile phones in urban space

A design for a novel mobile sensing system, called Temperature Measurement System Architecture (TMSA), that uses people as mobile sensing nodes in a network to capture spatiotemporal properties of pedestrians in urban environments is presented in this paper. In this dynamic, microservices approach, real-time data and an open-source IoT platform are combined to provide weather conditions based on information generated by a fleet of mobile sensing platforms. TMSA also offers several advantages over traditional methods using participatory sensing or more recently crowd-sourced data from mobile devices, as it provides a framework in which citizens can bring to light data relevant to urban planning services or learn human behaviour patterns, aiming to change users’ attitudes or behaviors through social influence. In this paper, we motivate the need for and demonstrate the potential of such a sensing paradigm, which supports a host of new research and application developments, and illustrate this with a practical urban sensing example.This work has been supported by FCT - Fundacao para a Ciencia e Tecnologia within the R&D Units Project Scope: UIDB/00319/2020. It has also been supported by na tional funds through FCT – Fundação para a Ciência e Tecnologia through project ˆ UIDB/04728/2020

Transabdominal pre-peritoneal (TAPP) versus totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair

Background: Hernia repair is one of the most frequently performed surgeries worldwide. Surgical treatment is usually successful in the majority of cases. However, a recurrence rate of 10% is reported irrespective of the surgical approach. Postoperative pain and disability are frequent. Laparoscopic repair has largely replaced open surgery in the treatment of inguinal hernia. Objectives: To evaluate TAPP and TEP laparoscopic techniques for treatment of inguinal hernia repair regarding safety and outcome. Patients and methods: This prospective randomized clinical trial study was carried out on 40 patients with inguinal hernia who underwent laparoscopic repair. Patients were distributed into 2 groups, group A patients had transabdominal preperitoneal (TAPP) repair while group B patients underwent totally extraperitoneal (TEP) repair. Both groups were evaluated according to occurrence of intraoperative complications, operative time, bleeding amount, hospital stay, postoperative pain (visual analogue scale) and duration for return of bowel movements. Results: There was no statistically significant difference between both groups in each studied parameter. However, there was significantly less postoperative pain in TAPP group (p-value= 0.008) and TEP group (p-value= 0.001). Conclusion: In conclusion, both TAPP and TEP achieved similar results in the parameters evaluated during this study. Both approaches can be used in the treatment of inguinal hernia repair

Evidence on the Heroin-Mediated Impairment of the Oxidative Status of Erythrocytes

Away from hemorheological properties, the effect of heroin addiction on erythrocytes is poorly investigated. This study aimed to investigate the oxidative impacts of heroin administration on erythrocytes. Study subjects included chronic intravenous heroin addicts and control subjects. Hematological analysis and redox parameters were measured, including serum concentration of methemoglobin ([MethHb]), serum glutathione peroxidase-1 ([GPX-1]), serum glutathione peroxidase (GPX) activity, erythrocytic protein carbonyl content, and oxidized to reduced glutathione (GSSG/GSH) ratio. Hematological analysis revealed that addicts had a significantly higher red cell distribution width, consistent with the mild anisocytosis and poikilocytosis of erythrocytes. As compared to control subjects, significantly higher levels of serum [Met-Hb], [GPX-1], and GPX activity (p<0.001) were reported among addicted subjects. A significant association between [MetHb] and GPX activity was observed with r = 0.764 (p<0.001). Furthermore, significantly higher erythrocytic protein carbonyl contents and GSSG/GSH ratio were evident among heroin addicts (p<0.005) that were significantly associated with r = 0.429 (p=0.01). Results demonstrate preliminary evidence that heroin addiction is implicated in impaired redox status of erythrocytes. Considering the pharmacokinetics of heroin, erythrocytic antioxidant mechanisms, and turnover rate, further investigation is required to evaluate the extent and clinical outcomes, especially upon over-dose administration