A 10 year review of idiopathic nephrotic syndrome in children: a single-centre experience, Johannesburg, South Africa

Dissertation submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Master of Science in Medicine Johannesburg, 2016Background: Idiopathic nephrotic syndrome (INS) is the commonest type of nephropathy seen in children. The histopathological types and steroid response patterns of INS have been changing over the years and this has been attributed to differences in ethnicity and geographical location. The aim of this study was to determine the steroid response pattern, renal histopathology and complications in a cohort of the children treated for INS by the Division of Paediatric Nephrology, CMJAH, Johannesburg, South Africa between 2004 and 2013. Method: A retrospective study was carried out to review the records of 163 children between the ages of 2 and 16 years managed for INS over a 10 year period. Results: The majority (111) of the 163 children were of the black racial group. There were 97 boys and 66 girls. The mean age of onset was 5.3 years ± 2.8, with the highest rate of INS seen in the 2-6 year age group (71.2%). Only 132/163 had a renal biopsy performed (MCD 52.3%, FSGS 43.2%, MesPGN 4.5%). The black race had a similar rate of MCD (38.8%) and FSGS (37.8%), while the white race had a higher rate of MCD (64.3%) when compared to FSGS (14.3%). Ninety four (57.7%) patients were steroid sensitive (SSNS) while 69 patients (42.3%) were steroid resistant (SRNS). Minimal change disease was the most common histopathological type seen in SSNS (60%), while FSGS was the most common observed in patients who had SRNS (65.2%). There was a statistically significant association between the various steroid response patterns and the different histopathological types. The highest rate of resistance to all treatment after a mean follow up of 60 months was seen among children of the mixed race and black racial groups (50.0% and 40.5% respectively). Stunted growth (52.1%), hypertension (47.2%) and reduced eGFR (25.8%) were the most common complications observed. Conclusions: There appears to be an increase in the rate of FSGS in all the racial groups, and an increase in the rate of MCD in the black race group, when compared to previous South African studies. Furthermore, steroid response was also observed to have increased significantly among the black racial group when compared with previous studies. Although hypertension was the most common complication observed in our cohort, a very high rate of stunted growth was also observed. This may be due to the significant number of patients with reduced eGFR, SRNS and FSGS in our cohort. The use of long term steroid therapy may have contributed to this high rate.MT201

The walk out of the rural kitchen : towards planning energy services for sustainable rural livelihoods in Sudan

This thesis is about rural energy services, the problems with accessibility and the consequences of\ud their inaccessibility on rural livelihoods in the traditional rural areas of Sudan. The thesis is\ud organised in six chapters. Chapter 1 starts by providing a background to the political and economic\ud context of Sudan, and introduces the energy planning efforts made, so far, in Sudan. The chapter\ud ends with formulating the research problem, the research objective and the research questions. It\ud shows how traditional rural areas are excluded from the benefits of modern energy access because\ud they are excluded at all stages of the energy planning process. Due to this exclusion, rural areas are\ud not served by modern energy carriers (petroleum and electricity) and continue to draw their energy\ud services from traditional energy carriers (wood, residues and animate sources). As a result,\ud Sudanese rural areas suffer the consequences of negative livelihoods outcomes (displacement, civil\ud unrest, war and many others hardships). The exclusion of rural areas from energy planning\ud processes can be divided into two forms: spatial exclusion and methodological exclusion

Ali Akbaş’ın Şiirlerini Makedoncaya Çevirmem (Промоција на книгата „Птичја софра“ на Али Акбаш во превод на Марија Леонтиќ во галеријата „Остен“ - Скопје во организација на турскиот културен центар „Јунус Емре“ - Скопје)

Промоцијата на книгата „Птичја софра“ на Али Акбаш во превод на Марија Леонтиќ се одржа во галеријата „Остен“ - Скопје во организација на турскиот културен центар „Јунус Емре“ - Скопје. Оваа презентација беше наменета за сите љубители на поезијата на турскиот поет Али Акбаш. Во презентацијата се изложи процесот на препевање на песните на Али Акбаш на македонски

Food safety knowledge and practices of street foodvendors in Atbara City (Naher Elneel State Sudan)

The study was conducted to evaluate the food safety knowledge and practices of street food vendors in Atbara city between March and April, 2008. The questionnaires respondents were 28% male and 72% were female, 48% of them had primary school education while 42% were illiterates. The most prevalent isolated bacteria from cooked meals, bottled drink and fresh juice were; Escherichia coli, Staphylococcus auerus and Bacillus sp. The viable bacterial counts were 4.6 CFU/ml, 3.7 CFU/ml and 4.1 CFU/ml for cooked meals, bottled drink and juice, respectively

Biomineralization of hydroxyethyl cellulose/sodium alginate impregnated with cellulose nanocrystals by using surface modification technique

Bone tissue engineering utilizes scaffolds fabricated from various biopolymeric materials to obtain a specific topography prior to seeding with specified cells and implantation into an injured body. The aim of this research is to synthesize biopolymeric materials from hydroxylethylcellulose (HEC) (5 wt%) blended with sodium alginate (SA)(10 wt%) at 1:1 ratio and incorporated with cellulose nanocrystals (CNC) (11 w/v%). The scaffolds was fabricated using the freeze-drying technique. For the mineralization process, these HEC/SA and HEC/SA/CNC scaffolds were treated with simulated body fluid (SBF) by immersion technique through the depositing of calcium phosphate on the scaffold’s surfaces. The behavior of scaffolds such as chemical structures and thermal properties were characterized by using FESEM, EDX, ATR-FTIR, and UTM. In-vitro biocompatibility of the scaffolds was investigated by culturing human fetal osteoblast (hFOB) cells on these scaffolds. The SEM images displayed interconnected porous structures with diameters ranging from 40 to 400 μm and porosity percentages ranging from 75 ± 5% to 90.5 ± 5 %. The high swelling ratio of HEC/SA untreated with SBF scaffold was ascribed to the strong hydrogen bonding and Van der Waals interactions between polymer chains. After 7 days of incubation, the scaffolds began to disintegrate, which leads to the increase in weight loss (simultaneously up to ~60%). ATR-FTIR results exhibit possible interactions between hydroxyl groups of HEC, SA and CNC in the blends suggests there is chemical interaction between scaffolds. The TGA results showed four different regions of mass losses, represents the degradation temperature and water disposal, side - chain bond breaking, pyrolysis of SA and dehydroxylation behavior of calcium phosphate, respectively. The cell-scaffolds interaction demonstrated that hFOB cells differentiated and spread well on the scaffolds with better cell proliferation and attachment on HEC/SA/CNC treated with SBF porous scaffolds. Since these biocompatible and biodegradable scaffolds showed promising results, these scaffolds could be adopted for the design of next-generation tissue-engineered bone grafts

Investigation of Agricultural Residues Gasification for Electricity Production in Sudan as an Example for Biomass Energy Utlization under Arid Climate Conditions in Developing Countries

This study examines the possibility of electricity production through gasification of agricultural residues in Sudan. The study begins in Chapter 1, by providing general contextual analysis of the energy situation (production and consumption patterns) in Sudan with specific focus on electricity. It proceeded to study the potential of Petroleum, Biomass and other renewable sources for electricity production. Dramatic increase in electricity production was found to be essential especially through decentralised power plants as the current electricity production services cover ~ 13 % of the population of Sudan. Biomass potential in Sudan justifies the use of agricultural residues as energy source; its potential was estimated by ~ 350000 TJ/a. Further, the urban centres of arid regions in western Sudan were identified as the target group for this study. In chapter 2, specific investigations for selected study area through field work using statistical tools such as questionnaires, interviews and field observation show that income is highly correlated to electricity consumption. The flat rate system did not result in higher consumption thus the assumption that this consumption will not drastically change in the next 10 years could be accepted. As orientation value for BGPP, 8000 tons of GN.S are available annually, the average electricity consumption is ~ 4 kWh/day/family while acceptable price could be 40 SDD/kWh (0.15 €). In chapter 3, literature review was carried to spot out the comparative merits of the gasification technology and the most optimum gasifying and electricity production system. As a result downdraft gasifier and ICE were suggested as suitable systems. In chapter 4, fuel properties and fuel properties of agricultural residues were studied, different samples were tested and the results were presented. The main conclusions derived were: fuel properties of agricultural residues are modifiable properties, so utlization planning is possible as for any other energy resource. In Sudan, Baggase, Groundnuts shells and Roselle stalks could be considered as possible fuels. The experimental work done in chapter 5 showed that GN.S could be gasified in down draft gasifiers, which are less costly and simpler to operate than circulating systems. Acceptable values of gas thermal properties (c.v.~ 4 MJ/Nm3, 30 % of burnable gases) at fairly continuing processes were obtained. In chapter 6, a concept for biomass power plant was drafted, the main components are: downdraft, air based gasifier connected to ICE, multi-stage gas cleaning system (cyclones, washer and filters) mechanical ash removal and semi closed water cycle. Main operation measures are: electricity is the sole product; working time is 150 day/year between mid Novembermid Mars. Environmental hazards of waste management e.g. flue gas emission and waste water management are the limiting factors. In the last part of chapter 6 an economic analysis was carried out. At a value of 3000 €/kW for the initial system and fuel price of 100000 €/year for ~6 GWh then a price of 0.23 €/kWh and a return period of 24 years could be obtained. The study concludes in chapter 7 that biomass gasification under the local conditions has its comparative merits however a high institutional support is needed at the beginning.Diese Studie untersucht die Möglichkeit der Elektrizitätsproduktion durch Vergasung von landwirtschaftlichen Abfällen im Sudan. Die Untersuchung beginnt im Kapitel 1 mit der Bereitstellung einer allgemeinen zusammenhängenden Analyse der Energiesituation (Produktions- und Verbrauchsmuster) im Sudan mit dem besonderen Fokus auf Elektrizität, gefolgt von einer Studie des Potentials von Petroleum, Biomasse und anderer erneuerbarer Quellen für die Produktion von Elektrizität. Eine starke Zunahme bei der Elektrizitätsproduktion wurde als nötig bewertet, da dezentrale Kraftwerke, als die gegenwärtigen Elektrizitätsproduktionsbetriebe, nur die Versorgung von 13 % der Bevölkerung im Sudan abdecken. Das geschätzte Potential der landwirtschaftlichen Abfälle liegt bei ca. 350.000 TJ/Jahre damit kommen sie als Energiequelle in Frage. Weiterhin wurden urbane Zentren der ariden Regionen in Westsudan als Zielgruppe für die Untersuchung ausgewählt. In Kapitel 2 werden detaillierte Untersuchungen für das ausgewählte Studiengebiet durch Feldstudien unter Verwendung von statistischen Werkzeugen, wie Fragebögen, Interviews und Felduntersuchungen dargestellt. Das Ergebnis zeigt, dass das Einkommen im höchsten Maße mit dem Elektrizitätsverbrauch korreliert ist. Das Flat rate System hatte keinen höheren Verbrauch zur Folge, folglich kann die Annahme akzeptiert werden, dass sich der Verbrauch in den nächsten 10 Jahren nicht drastisch ändern wird. Als Orientierungswert für Biomasse Kraftwerk: 8.000 t/Jahr Erdnussschalen sind verfügbar. Der durchschnittliche Elektrizitätsverbrauch beträgt ca. 4 kWh/Tag/Familie betrachtet für 10.000 Familien. Im Kapitel 3 wird eine Literaturrecherche für die Vergasungstechnologie durchgeführt, zum Vergleich ihrer Vorteile und zur Auswahl des optimalen Vergasungs- und Gasumwandlungssystems. Als Ergebnis wurden der Festbett-Gleichstrom-Vergaser und gas Motor als passende Systeme vorgeschlagen. In Kapitel 4 werden Brennstoff Eigenschaften von landwirtschaftlichen Abfällen untersucht, verschiedene Proben getestet und die Ergebnisse präsentiert. Die Hauptschlussfolgerung daraus ist: Brennstoff Eigenschaften von landwirtschaftlichen Abfällen sind veränderbare Eigenschaften, welche eine bessere Planung erlauben und somit ihre Verwendung favorisieren. Im Sudan können Bagasse, Erdnussschalen und Rosellenstiele als optimaler Brennstoff gelten. Die experimentelle Arbeit in Kapitel 5 zeigt, dass Erdnussschalen im 75 kW Festbett-Gleichstrom-Systemen vergast werden können, welche weniger kostenintensiv und einfach zu bedienen sind als zirkulierende Systeme. Akzeptable Werte der Gaseigenschaften (c.v. ca. 4 MJ/Nm³, 35 % von brennbaren Gasen) wurden in kontinuierlichen Prozessen erreicht. In Kapitel 6 wurde ein Konzept für Biomassekraftwerke entworfen. Deren Hauptkomponenten sind: Festbett-Gleichstrom-Vergaser in Verbindung mit ICE, mehrstufige Gasreinigungssysteme (Zyklone, Wäscher und Filter), mechanische Aschensysteme und ein teilweise geschlossener Wasserkreislauf. Hauptbetriebsmaßnahmen sind: Elektrizität als das einzige Produkt, die Arbeitszeit beträgt 150 Tage pro Jahr zwischen November und April. Umweltrisiken des Abfallmanagements z.B. Rauchgas und Abwassermanagement sind die limitierenden Faktoren. Im letzten Teil von Kapitel 6 wurde eine ökonomische Analyse durchgeführt. Ein Wert von 3000 €/kW für das Anfangssystem und ein Kraftstoffpreis von 100.000 €/Jahr für 6 GWh dann ein Preis von 0,23 €/kWh und eine Amortisationszeit von 24 Jahren können angenommen werden. Die Studie schlussfolgert, dass die Vergasung unter den Bedingungen des Studiengebietes ihre Vorteile hat, jedoch ist institutionelle Unterstützung am Anfang nötig

Re-calibrating and Re-standardization of Teacher Rating Scale of the Characteristics of Gifted Children in Basic Education Phase Using Rasch Model

The Arabic scale for teachers' rating of basic education gifted students' characteristics is considered one of the commonest Arabic measures used for initial identification of gifted students in some Arabic countries. One of the shortcomings of this scale, however, is that it is based on the classical theory of measurement. This study sought to recalibrate and re-normalize the scale in the light of Rasch's unidemisional model which rests upon the modern theory of measurement and to develop different criteria for interpreting the levels of individuals' traits. The scale was administered to 830 Basic Education students in Khartoum (age ranged from 7 to 12 years). Two groups of students participated in the study: a calibration sample (N = 250) and a standardization sample (N = 580). The statistical treatments were performed using the PSAW 18 and RUMM 2020 programs according to Rasch's unidimentional model. Six of the scale items were deleted for not conforming to Rasch's model. This left the scale with 31 items. Besides, new criteria for the scale were developed by obtaining the tscores that match the various ratings of the individuals' ability

Gunshot Injuries: Patterns, Presentations, and Outcomes of Civilian Hospital Experiences in a Developing Country Setting

Background: Gunshot injuries are considered a health burden as well as one of the intricate emergencies in civilian medical practice. In this study, we aim to determine the pattern of presentation and management outcome in a general hospital setting in a sub-Saharan African country.Methods: This is a retrospective, hospital-based study conducted between January 2015 and December 2019 in a general teaching hospital to review the clinical presentation and management outcome of gunshot injuries. All patients’ records were reviewed during the study period.Results: The total number of patients involved in the study was 157 with 83% male predominant. About 50% were from the age group 20–29 years that were most affected. The commonest anatomical site affected in the study was the lower limb (41.4%) and upper limb (22.9%), and most of the patients had been diagnosed with limb fractures (49.7%) and soft tissue injuries (28.7%). Wound debridement is the commonest procedure performed for 91 (58.0%) patients. The site of the pullet has a significant relation to the management outcome with a P-value of 0.002. Additionally, about 45% (72 patients) have stayed more than 20 days and it was affected significantly by the types of treatment provided, which has a significant relation to a hospital stay with a P-value of 0.00.Conclusion: Most of the patients in this study were young males. Upper and lower limb fractures were the most common presentations. Wound debridement, bone fixation, and laparotomy were the most common treatments with significant success rates, despite prolonged hospital stays

Productive Performance of F1- (Damascus Goat × Desert) under Traditional Management in North Kordofan

This study carried out in North Kordofan state, Western Sudan (latitudes 12:15-16:32 N and longitudes 27-32 E), during the period Feb 2018 - Aug 2021 to assessment the productive and reproductive performance of crossed F1 (Desert× Damascus) under the traditional management systems, to evaluate adaptation of crossed to environmental conditions of study area, to study milk production of the crossed goats. 44 females crossed goat F1 (Damascus×Desert goat) were selected at weaning age. Two mature Damascus bucks were used in the experiment all animals were identified using ear tags and treated against external and internal parasites. All animals will set free during the day and kept in closed pen during the night. The behavior of the animals and the adaptation on the environment was observed and recorded in addition to any problems like disease; Data were analyzed using the Statistical Package for Social Sciences, software package (SPSS, V23, 2017). In this study, the Damascus Bucks were severely affected under the conditions of nature grazing and suffered from parasites and high temperature, Bucks have died as a result of tick fever according to Anatomical symptoms, The parameters of dams varied according to litter size, Females were born as a single reached puberty at (278.2±7 days) with body weight of 20.01 kg while the twins females was puberty age (291.6±9 days), and weight was 16.91kg , The average lactation period was 120 days with average total milk production of 40.46± 1.74 kg, this study conclude that the crossed Females are late in sexual maturity, So The genetic cross as a way to improve the herd without taking into account environmental conditions does not lead to the desired results.&nbsp

Idiopathic nephrotic syndrome in South African children.

Background: Different histo-pathological types and treatment response patterns of Idiopathic nephrotic syndrome (INS) have been associated with differences in ethnicity and geographical location.Objective: To provide an update on the steroid response and renal histo-pathological pattern in children treated for INS.Method: Medical records of children with INS treated at the Charlotte Maxeke Johannesburg Academic Hospital were reviewed.Results: Mean age was 5.3 years ± 2.8. The majority (68.1%) of the 163 children were of the black racial group. The highest rate of INS was seen in the 2-6 year age group (71.2%). The black racial group had the highest rate (42/111; 37.8%) of focal segmental glomerulosclerosis (FSGS), and the white race had the highest rate (9/14; 64.3%) of minimal change disease (MCD). Ninety four (57.7%) patients were steroid sensitive (SSNS) while 69 patients (42.3%) were steroid resistant (SRNS). Minimal change disease was the most common histo-pathological type seen in SSNS (60%), while FSGS was the most common observed in patients who had SRNS (65.2%).Conclusion: There appears to be a higher rate of FSGS in all the racial groups, and also a higher rate of MCD in the black race group, when compared to previous reports.Keywords: Idiopathic, nephrotic syndrome, children