Colonoscopy at El Obeid Hospital, Western Sudan

Background: Colonoscopy is effective in screening, diagnosis and treatment of colorectal problems.Objective: The objective of this study was to highlight the impact of colonoscopy service on the pattern and management of lower gastrointestinal diseases as appeared after its introduction for the first time in El Obeid, Western Sudan.Materials and methods: The records of individuals who underwent colonoscopy at El Obeid Hospital were reviewed. The data were analyzed for gender, age, indications, pathology revealed and the outcomes of the procedures.Results: Out of 160 colonoscopies performed, there were 108 males (67.5%). The age ranged between 17 and 85 years. The main indications were rectal bleeding, irregular bowel habits and lower abdominal pain. 28.1% of the individuals were found to be normal. 28.0% of the patients had colitis and 2.5% had diverticular disease. Cancer was diagnosed in 10.1% of cases while benign polyps were found in 7.5% of the patients and internal piles were seen in 14.4% of cases. 9.4% of the patients were emergency procedures for acute sigmoid volvulus. Apart from the discomfort and non-frequent nausea, no other complications like rectal bleeding or colonic perforations were encountered among the study group.Conclusion: Colonoscopy is a safe and useful procedure. Expansion of the service and more training is recommended to supplement diagnosis and facilitate therapeutic measures.Key words: Colonoscopy, Western Sudan

Eyelid Localization for Iris Identification

This article presents a new eyelid localization algorithm based on a parabolic curve fitting. To deal with eyelashes, low contrast or false detection due to iris texture, we propose a two steps algorithm. First, possible edge candidates are selected by applying edge detection on a restricted area inside the iris. Then, a gradient maximization is applied along every parabola, on a larger area, to refine parameters and select the best one. Experiments have been conducted on a database of 151 iris that have been manually segmented. The performance evaluation is carried out by comparing the segmented images obtained by the proposed method with the manual segmentation. The results are satisfactory in more than 90% of the cases

Fine Needle Aspiration Cytology for Suspected Tuberculous Lymphadenitis: A Feasible Solution for a Diagnostic Dilemma in Sudan

Background: Tuberculosis is a common health problem in Sudan. Tuberculous lymphadenitis is one of the most frequent causes of lymphadenopathy. In most of these cases sputum as well as other diagnostic routine tests are negative.Objective: To evaluate the usefulness of fine needle aspiration cytology (FNAC) as a diagnostic tool for tuberculous lymphadenitis and to describe the cytomorphology of the smears.Material and Methods: This is a prospective hospital-based study conducted in Khartoum during the period from February 2011 to January 2012. Eighty five patients with a clinical suspicion of tuberculous lymphadenopathy were included. Direct smears were prepared and stained with Diff Quick (DQ) and Ziehl-Neelsen (ZN) stains.Results: of the 85 patients, 52 (61.2%) were females with 1.5:1 female to male ratio. The mean age was 31.6 years (range 2 - 70 years). The most frequent site involved was the cervical lymph node group,58 (68.2%) cases. Seventy five (88.3%) smears showed necrotizing granulomatous lymphadenitis (with or without detected epithelioid cells), and 10 (11.7%) smears were non necrotizing granulomatous lymphadenitis, only epithelioid and inflammatory cells detected. Positive smears for acid fast bacilli (AFB) by ZN stain were observed in 40 (47%) cases.Conclusion: FNAC is a simple and inexpensive method for diagnosis of tuberculous lymphadenitis, and can obviate the need for surgical excision. Combination of FNAC with ZN stain is valuable and recommended as first line diagnostic modality in suspected cases.Keywords: Fine Needle Aspiration Cytology, Tuberculous lymphadenitis, Acid fast bacilli

The safety of artemisinins during pregnancy: a pressing question

BACKGROUND: An increasing number of countries in sub-Saharan Africa are changing to artemisinins combination therapy (ACT) as first or second line treatment for malaria. There is an urgent need to assess the safety of these drugs in pregnant women who may be inadvertently exposed to or actively treated with ACTs. OBJECTIVES: To examine existing published evidence on the relationship between artemisinin compounds and adverse pregnancy outcomes and consider the published evidence with regard to the safety of these compounds when administered during pregnancy. METHODS: Studies on ACT use in pregnancy were identified via searches of MEDLINE, EMBASE, Cochrane and Current Contents databases. Data on study characteristics, maternal adverse events, pregnancy outcomes and infant follow up were extracted. RESULTS: Fourteen relevant studies (nine descriptive/case reports and five controlled trials) were identified. Numbers of participants in these studies ranged from six to 461. Overall there were reports on 945 women exposed to an artemisinin during pregnancy, 123 in the 1st trimester and 822 in 2nd or 3rd trimesters. The primary end points for these studies were drug efficacy and parasite clearance. Secondary endpoints were birth outcomes including low birth weight, pre-term birth, pregnancy loss, congenital anomalies and developmental milestones. While none of the studies found evidence for an association between the use of artemisinin compounds and increased risk of adverse pregnancy outcomes, none were of sufficient size to detect small differences in event rates that could be of public health importance. Heterogeneity between studies in the artemisinin and comparator drugs used, and in definitions of adverse pregnancy outcomes, limited any pooled analysis. CONCLUSION: The limited data available suggest that artemisinins are effective and unlikely to be cause of foetal loss or abnormalities, when used in late pregnancy. However, none of these studies had adequate power to rule out rare serious adverse events, even in 2(nd )and 3(rd )trimesters and there is not enough evidence to effectively assess the risk-benefit profile of artemisinin compounds for pregnant women particularly for 1(st )trimester exposure. Methodologically rigorous, larger studies and post-marketing pharmacovigilance are urgently required

Evidence for the classical integrability of the complete AdS(4) x CP(3) superstring

We construct a zero-curvature Lax connection in a sub-sector of the superstring theory on AdS(4) x CP(3) which is not described by the OSp(6|4)/U(3) x SO(1,3) supercoset sigma-model. In this sub-sector worldsheet fermions associated to eight broken supersymmetries of the type IIA background are physical fields. As such, the prescription for the construction of the Lax connection based on the Z_4-automorphism of the isometry superalgebra OSp(6|4) does not do the job. So, to construct the Lax connection we have used an alternative method which nevertheless relies on the isometry of the target superspace and kappa-symmetry of the Green-Schwarz superstring.Comment: 1+26 pages; v2: minor typos corrected, acknowledgements adde

Modeling methanogenesis with a genome-scale metabolic reconstruction of Methanosarcina barkeri

We present a genome-scale metabolic model for the archaeal methanogen Methanosarcina barkeri. We characterize the metabolic network and compare it to reconstructions from the prokaryotic, eukaryotic and archaeal domains. Using the model in conjunction with constraint-based methods, we simulate the metabolic fluxes and resulting phenotypes induced by different environmental and genetic conditions. This represents the first large-scale simulation of either a methanogen or an archaeal species. Model predictions are validated by comparison to experimental growth measurements and phenotypes of M. barkeri on different substrates. The predicted growth phenotypes for wild type and mutants of the methanogenic pathway have a high level of agreement with experimental findings. We further examine the efficiency of the energy-conserving reactions in the methanogenic pathway, specifically the Ech hydrogenase reaction, and determine a stoichiometry for the nitrogenase reaction. This work demonstrates that a reconstructed metabolic network can serve as an analysis platform to predict cellular phenotypes, characterize methanogenic growth, improve the genome annotation and further uncover the metabolic characteristics of methanogenesis

Burden of visceral leishmaniasis in villages of eastern gedaref state, Sudan: an exhaustive cross-sectional survey.

Since December 2009, Médecins Sans Frontières has diagnosed and treated patients with visceral leishmaniasis (VL) in Tabarak Allah Hospital, eastern Gedaref State, one of the main endemic foci of VL in Sudan. A survey was conducted to estimate the VL incidence in villages around Tabarak Allah

The interaction between a sexually transferred steroid hormone and a female protein regulates oogenesis in the malaria mosquito anopheles gambiae

Molecular interactions between male and female factors during mating profoundly affect the reproductive behavior and physiology of female insects. In natural populations of the malaria mosquito Anopheles gambiae, blood-fed females direct nutritional resources towards oogenesis only when inseminated. Here we show that the mating-dependent pathway of egg development in these mosquitoes is regulated by the interaction between the steroid hormone 20-hydroxy-ecdysone (20E) transferred by males during copulation and a female Mating-Induced Stimulator of Oogenesis (MISO) protein. RNAi silencing of MISO abolishes the increase in oogenesis caused by mating in blood-fed females, causes a delay in oocyte development, and impairs the function of male-transferred 20E. Co-immunoprecipitation experiments show that MISO and 20E interact in the female reproductive tract. Moreover MISO expression after mating is induced by 20E via the Ecdysone Receptor, demonstrating a close cooperation between the two factors. Male-transferred 20E therefore acts as a mating signal that females translate into an increased investment in egg development via a MISO-dependent pathway. The identification of this male–female reproductive interaction offers novel opportunities for the control of mosquito populations that transmit malaria

A List Scheduling Heuristic with New Node Priorities and Critical Child Technique for Task Scheduling with Communication Contention

Task scheduling is becoming an important aspect for parallel programming of modern embedded systems. In this chapter, the application to be scheduled is modeled as a Directed Acyclic Graph (DAG), and the architecture targets parallel embedded systems composed of multiple processors interconnected by buses and/or switches. This chapter presents new list scheduling heuristics with communication contention. Furthermore, we define new node priorities (top level and bottom level) to sort nodes, and propose an advanced technique named critical child to select a processor to execute a node. Experimental results show that the proposed method is effective to reduce the schedule length, and the runtime performance is greatly improved in the cases of medium and high communication. Since the communication cost is increasing from medium to high in modern applications like digital communication and video compression, the proposed method is well-adapted for scheduling these applications over parallel embedded systems

The M3 muscarinic receptor Is required for optimal adaptive immunity to Helminth and bacterial infection

Innate immunity is regulated by cholinergic signalling through nicotinic acetylcholine receptors. We show here that signalling through the M3 muscarinic acetylcholine receptor (M3R) plays an important role in adaptive immunity to both Nippostrongylus brasiliensis and Salmonella enterica serovar Typhimurium, as M3R-/- mice were impaired in their ability to resolve infection with either pathogen. CD4 T cell activation and cytokine production were reduced in M3R-/- mice. Immunity to secondary infection with N. brasiliensis was severely impaired, with reduced cytokine responses in M3R-/- mice accompanied by lower numbers of mucus-producing goblet cells and alternatively activated macrophages in the lungs. Ex vivo lymphocyte stimulation of cells from intact BALB/c mice infected with N. brasiliensis and S. typhimurium with muscarinic agonists resulted in enhanced production of IL-13 and IFN-γ respectively, which was blocked by an M3R-selective antagonist. Our data therefore indicate that cholinergic signalling via the M3R is essential for optimal Th1 and Th2 adaptive immunity to infection