Synthesis, mass spectroscopic studies, cytotoxicity evaluation and quantitative structure activity relationship of novel isoindolin-1,3-dione derivatives

3-Amino-4,6-diphenyl-2H-pyrazolo[3,4-b]pyridine (5) was synthesized as starting material and investigated as cytotoxic and antitumor agent. Compound 5 reacted with different acid anhydrides to afford the corresponding imides and bisimide derivatives 6-12. Imides 6-12 were tested for their in vitro cytotoxicity against four different cancer cell lines and structure activity relationship’s (SAR’s) was studied. Keywords: 2-Thiomethyl-4,6-diphenyl-3-carbonitrilpyridine, Acid Anhydrides, Cytotoxicity

Prevention of Hepatitis B Virus and Hepatitis C Virus Transmission in Hemodialysis Centers: Review of Current International Recommendations

Introduction: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in hemodialysis (HD) patients are associated with adverse outcomes, especially after kidney transplantation. Review: In the HD setting, cross-contamination to patients via environmental surfaces, supplies, equipment, multiple-dose medication vials and staff members is mainly responsible for both HBV and HCV transmission. The incidence and prevalence of HBV in HD centers have dropped markedly as a result of isolation strategy for HBsAg positive patients, the implementation of infection control measures and the introduction of HBV vaccine. The incidence and prevalence of HCV infection among HD patients remain higher than the corresponding general population. There is ongoing debate as to whether isolation of HCV infected patients is needed to combat high anti-HCV seroconversion rates. The current guidelines do not recommend isolation or the use of dedicated machines for HCV infected patients, and rely on strict adherence to infection control measures for the prevention of HCV transmission in the HD setting. Investigations of dialysis associated outbreaks of HCV infection indicate that transmission most likely occurs because of inadequate infection control practices. Routine screening of anti-HCV negative patients, with HCV-antibody testing, and monthly monitoring of ALT levels is recommended to monitor transmission within centers. Conclusion: Prevention of transmission of HBV and HCV in the HD setting warrants a multi-faceted approach. Not enough stress can be placed on the importance of adequate infection control practices for the prevention of both infections. Prevention of HBV transmission is augmented by correct implementation of isolation strategies and the universal vaccination of susceptible patients. Keywords: Hemodialysis; Hepatitis B Virus; Hepatitis C Virus; Infection Control; Isolatio

Reaching Target Hemoglobin Level and Having a Functioning Arteriovenous Fistula Significantly Improve One Year Survival in Twice Weekly Hemodialysis

Introduction: This is a prospective study of a cohort of 1011 patients maintained on regular hemodialysis (HD) in Khartoum, Sudan, studied in the year 2009 and reevaluated one year later. Their survival rates in November 2010 were related to their baseline characteristics.Methods: Demographic and clinical data of studied patients was collected by direct patient interviews and dialysis records revision. Survival rates were calculated using the Kaplan Meier method.Results: Patients had a median age of 45 years and a median duration on dialysis of 25 months. Two thirds of patients were males and 4.2% were children. Studied patients had a one-year survival rate of 86%. Mostpatients (74.8%) received twice weekly HD, and their survival rate was lower than patients receiving thrice weekly HD (85% versus 89%, P = 0.06). The strongest independent predictors of mortality were lack of adocumented measure of dialysis adequacy (HR = 2.7, P =0.00), poor functional capacity (HR = 2.4, P = 0.00), lack of a functioning AV fistula (HR = 2.0, P = 0.00), age . 65 years (HR = 1.6, P = 0.02) and  cardiovascular disease (HR = 1.5, P = 0.04). Patients with hemoglobin level < 10 g/dl had significantly lower survival rates (81% versus 92%, P = 0.00) compared to other patients. HD patientsf perception of their own general health was also significantly correlated to their survival rates (P = 0.00).Conclusion: Patients on thrice weekly HD did marginally better than those on twice weekly HD. In the latter group, however, having an AV fistula and a hemoglobin level of > 10 g/dl appeared to have a positive effect on theirsurvival. Twice weekly HD could be acceptable for many patients provided other aspects of renal care are cared for adequately

Chronic Kidney Disease in Police Forces Households in Khartoum, Sudan: Pilot Report

Introduction: In the Police Forces Hypertension, Diabetes, Renal Insufficiency and Thyroid Derangement (HyDRIT) pilot study we explored the prevalence, risk factors, awareness, treatment adequacy and complications of chronic kidney disease (CKD) and other non-communicable diseases among adult Police Forces households in two housing complexes in Khartoum, Sudan. Methods: Serum creatinine measurements and urine dipstick testing were performed for 273 individuals. The glomerular filtration rate (GFR) was estimated using the standardized Cockroft-Gault and the four variable MDRD formulas. CKD was defined as an estimated GFR of less than 60 ml/min/1.73m2 and/or proteinuria. Results: The overall prevalence of CKD was 11% (30/273) using the standardized Cockroft-Gault equation and 7.7% (21/273) using the four variable MDRD equation. According to the standardized Cockroft-Gault formula, 14 subjects had reduced GFR with negative urine dipstick testing, two subjects had both proteinuria and reduced GFR, and 14 subjects had proteinuria without reduction in GFR. None of those subjects was aware of his kidney problem. According to the standardized Cockroft-Gault formula, 14 of the identified CKD cases were hypertensive (46.7%); eight of them (57.1%) had a prior diagnosis of hypertension but none achieved therapeutic targets. Four of the identified CKD cases were diabetic (13.3%), three of whom had a prior diagnosis of diabetes mellitus with reasonably controlled blood sugar levels. Only age above 50 years and low educational level proved to be independent risk factors for CKD in multivariate analysis. Conclusion: The prevalence of CKD in the study population seems to be comparable to other countries. Keywords: awareness, chronic kidney disease, diabetes mellitus, hypertension, prevalence, Suda

The Sudan Peritoneal Dialysis Program: Three Years of Momentum

Introduction: End stage renal disease (ESRD) is a significant social and economic burden on Africa. Continuous ambulatory peritoneal dialysis (CAPD) was introduced as a national service in the Sudan three years ago. An overview of the Sudan Peritoneal Dialysis Program is presented. Review: As a national scheme, the Sudan PD program was sequentially launched in seven centers in Sudan. CAPD was the modality exclusively utilized. The total number of patients enrolled by July 2008 was 232. Patients' mean age was 43 years, 23.5% were children, 63% were males, and 19% were diabetic. PD was the initial dialysis modality for 54.7% of patients, 43.5% were referred from HD, and 1.9% had a failed kidney transplant. The majority of patients (62.3%) chose PD as the preferred dialysis modality, while the remainder were referred from HD to PD because of vascular access problems or hemodynamic instability. One third of patients required assisted PD, and 17% needed urgent initiation of dialysis. The cumulative peritonitis rate was one episode per 10.8 patient months. Touch contamination, urgent initiation of dialysis and execution of dialysis by family members other than trained helpers were among the identified predisposing factors. Conclusion: The establishment and operation of the Sudan PD program over the past three years have indicated that it is a promising project with multifaceted success. There is, however, an ongoing need for retraining of patients and staff. Early selection and careful preparation for potential PD candidates is also of vital importance to reduce the need for urgent dialysis initiation. Key words: peritoneal dialysis, CAPD, renal replacement therapy, Sudan, Afric

Renal Replacement Therapy in Sudan, 2009

Introduction: Despite an early start, the provision of renal replacement therapy (RRT) in Sudan is constrained by economic factors. This report describes the ESRD population and the available renal replacement therapy (RRT) services in Sudan in 2009. Current status: In June 2009, there were 2858 patients on hemodialysis (HD) in Sudan, 122 patients on continuous ambulatory peritoneal dialysis (CAPD), and 1168 kidney transplant recipients. The overall prevalence of treated ESRD was 106 patients per million population. All forms of RRT were funded by the government. The mean age of HD, CAPD and kidney transplant patients was 46±17, 42±22 and 39±13 years respectively. Males constituted 66%, 67.7% and 79.5% and children constituted 3.9%, 25.3% and 6.6% of HD, CAPD and kidney transplant patients respectively. The commonest reported cause of kidney failure was hypertension (26.1%), followed by diabetes mellitus (DM) (10.4%), obstructive uropathy (7.6%), glomerulonephritis (GN) (5.5%), polycystic kidney disease (2.6%), and pyelonephritis (1.1%). The majority of HD patients (83.8%) are offered twice-weekly HD, 83.6% had a functioning arterio-venous (AV) fistula, 6.4% were positive for hepatitis B virus (HBV) infection, 6.5% were positive for hepatitis C virus (HCV) infection, and 0.7% were positive for both HBV and HCV. Target blood pressure, hemoglobin and phosphorus levels were achieved by 26.5%, 23.1% and 28.5% of HD patients compared to 41.8%, 20.6% and 63.5% of CAPD patients respectively. Kidney transplant recipients had their transplant operation performed in Sudan (33.1%), Egypt (20.7%), KSA (18.2%), Jordan (14.8%), Pakistan (8.4%) and other countries. Conclusion: The prevalence of RRT in Sudan remains low. Hypertension and diabetes mellitus are the most commonly reported cause of kidney failure. Keywords: End stage renal disease; Hemodialysis; Kidney transplant; Peritoneal dialysis; Renal replacement therapy; Suda

Renal Replacement Therapy Resources in Africa

Background: Africa is the world’s second-largest and most-populous continent. It is also the world’s poorest inhabited continent. Regarding chronic kidney disease (CKD), there are no reliable statistics in most African countries. However, there is a general impression that it is at least three to four times more frequent than in more developed countries Methods: a survey on renal replacement therapy in Africa was conducted in the context of the African Association of Nephrology (AFRAN) Congress 2007. A questionnaire was sent to leading African nephrologists, and data were also collected from the main dialysis supply companies and by personal communication. Data have been obtained from 32 out of 54 countries, representing 89% of the total population. Results: There are no reliable statistics regarding CKD in most African countries. The total number of nephrologists in the continent is 1154 (1-4 pmp). The total number of patients on hemodialysis (HD) is just over 60000 patients

Effect of Light Intensity on the Total Flavonoid and Total Phenolic Contents of Mikania Micrantha and Tridax Procumbens

Flavonoid and phenolics are secondary metabolites produced by plants in response to harsh environmental conditions. Light is one of the most important factor that affects their production. Mikania micrantha and Tridax procumbens are plants belonging to Asteraceae family, and they have bioactivity due to their flavonoid and phenolic contents. The objective of the research is to determine the effect of varying light intensities on the total flavonoid and total phenolic contents of M. micrantha and T. procumbens using three solvents (ethanol, methanol and water). Total flavonoid contents was determined based on the aluminium chloride colorimetry method while total phenolic contents was determined based on the folin-chiocalteau reagent. The results obtained in the study shows that ethanol recovers more flavonoid and phenolic than the other solvents (P < 0.05). Besides, T. procumbens had more flavonoid and phenolic content compared to M. micrantha (P < 0.05). Nevertheless, the flavonoid and phenolic contents recovered from sun exposed plants was more than that recovered from shaded plants (P < 0.05). This leads to a conclusion that high light intensity can increase the concentration of flavonoid and phenolic of M. micrantha and T. procumbens

Effect of light intensity on the photosynthesis and stomatal density of selected plant species of Gunung Ledang, Johor

Light intensity influences the photosynthesis and stomatal density in plants. In this study, it was hypothesized that if the transpiration rate of a plant is low, then the stomatal density might be high. The objective of this research is to investigate the effect of varying light intensity on the photosynthetic capacity and stomatal density of Mikania micrantha, Tridax procumbens, Clidemia hirta and Centella asiatica plant species of Gunung Ledang, Johor, Malaysia. Sun-exposed and shaded species were selected for the study. Gas exchange characteristics including stomatal conductance to water vapour (gsw), transpiration rate and intracellular CO2 (Ci) were measured using LI-6400 portable photosynthesis system while net assimilation rate (Anet), light saturation point (LSP), light compensation point (LCP), and apparent quantum yield (Aqy) were calculated from the photosynthetic light response curve. Stomatal density was determined using nail polish impression method and examined using a stereo microscope. The result of this study shows that high light intensity influences the net assimilation rate and stomatal density of the studied plants. As the light intensity increases, Amax, LSP, LCP and stomatal density of the plants increases. There is a significant difference between the light response characteristics and stomatal density of the sun-exposed and shaded species (P < 0.05). A statistically significant negative correlation (P < 0.05) was achieved among stomatal density and transpiration rate. As stomatal density increases, the transpiration rate decreases. The result leads to a conclusion that Mikania micrantha can efficiently utilise the amount of light available more than Tridax procumbens, Clidemia hirta and Centella asiatica and grow abundantly as dominant species in an introduced environment

Influence of Light Intensity on the Photosynthesis and Phenolic Contents of Mangifera Indica

Light is an important environmental factor that have an influence on a plants photosynthesis and production of secondary metabolites like phenolic compounds and flavonoid. Mangifera indica from the family Anacardiaceae is known to have bioactivity due to its phenolic and flavonoid contents. The objective of the study is to determine the influence of light on the photosynthesis and phenolic contents of M. indica. Photosynthesis of the plant was measured using a portable photosynthesis system referred to as LICOR- 6400. Photosynthetic pigments as well as phenolic and flavonoid contents were quantified using a UV-VIS spectrophotometer. The outcome derived from the study shows that sun exposed leaves of the studied plant were having the maximum photosynthesis, saturation and compensation points (P &lt; 0.05).  Moreover, sun exposed leaves were having higher carotenoid, phenolic and flavonoid contents but lower chlorophyll contents. This leads to a conclusion that sun leaves of M. indica contribute the highest photosynthesis and phenolic contents to the plant