SERUM ZINC LEVELS IN SUDANESE PATIENTS WITH ACUTE LYMPHOCYTIC LEUKEMIA

Background: Zinc acts as growth protector for neoplastic cells and its deficiency was contributed to carcinogenesis. However, the determinations of serum zinc in acute lymphocytic leukemia (ALL) prediction and prognosis requires more investigations. Objective: To evaluate and compare serum zinc in ALL patients and healthy controls and to correlate the serum zinc levels with hematological prognostic markers. Materials and methods: The study was conducted in Khartoum state-Sudan during the period from December 2013 to September 2014, it involved a case group of ALL patients (N=100) matched for age and gender with a control group (N=100). Serum copper and zinc levels and full blood count were investigated. Results: The ALL patients showed lower levels of Zn 0.73 ± 0.18 mg/dl compared to controls 1.01 ± 0.25 mg/dl [P = 0.003]. The serum Zn levels were inversely correlated with total white cell (-0.804, P < 0.0001) and blast counts (-0.935, P < 0.0001). Conclusion: These findings ALL associated with lower serum zinc levels and higher serum copper levels. The determination of serum zinc and copper could be used as ALL prognostic markers. KEYWORDS: Acute lymphoblastic leukemia; Zinc; Carcinogenesis

SERUM ZINC LEVELS IN SUDANESE PATIENTS WITH ACUTE LYMPHOCYTIC LEUKEMIA

Background: Zinc acts as growth protector for neoplastic cells and its deficiency was contributed to carcinogenesis. However, the determinations of serum zinc in acute lymphocytic leukemia (ALL) prediction and prognosis requires more investigations. Objective: To evaluate and compare serum zinc in ALL patients and healthy controls and to correlate the serum zinc levels with hematological prognostic markers. Materials and methods: The study was conducted in Khartoum state-Sudan during the period from December 2013 to September 2014, it involved a case group of ALL patients (N=100) matched for age and gender with a control group (N=100). Serum copper and zinc levels and full blood count were investigated. Results: The ALL patients showed lower levels of Zn 0.73 ± 0.18 mg/dl compared to controls 1.01 ± 0.25 mg/dl [P = 0.003]. The serum Zn levels were inversely correlated with total white cell (-0.804, P < 0.0001) and blast counts (-0.935, P < 0.0001). Conclusion: These findings ALL associated with lower serum zinc levels and higher serum copper levels. The determination of serum zinc and copper could be used as ALL prognostic markers. KEYWORDS: Acute lymphoblastic leukemia; Zinc; Carcinogenesis

TLTF in cerebrospinal fluid for detection and staging of T. b. gambiense infection

Background: Trypanosome-derived lymphocyte triggering factor (TLTF) is a molecule released by African trypanosomes that interacts with the host immune system, resulting in increased levels of IFN-c production. Methodology/Principal findings: TLTF and anti-TLTF antibodies were assessed in sera and cerebrospinal fluid (CSF) from patients infected with Trypanosoma brucei gambiense (T. b. gambiense) in an attempt to identify alternative markers for diagnosis and stage determination of human African trypanosomiasis or sleeping sickness. Seventy-four serum and sixtyone CSF samples from patients with parasitologically confirmed infection and known disease stage along with 13 sera and CSF from uninfected controls were tested. In serum the levels of anti-TLTF antibodies were unrelated to the disease stage. In contrast, levels of anti-TLTF antibodies in CSF were higher in intermediate/late stages than in early stage disease patients. Specificity of the detected antibodies was assessed by inhibition of TLTF bioactivity as represented by its ability to induce IFN-c production. Additionally, TLTF was detected in CSF from late stage patients by Western blotting with the anti-TLTF specific monoclonal antibody MO3. Conclusions/Significance: These findings suggest a new possibility for disease diagnosis with focus on involvement of the CNS through detection of TLTF and anti-TLTF antibodies in the CSF

THE BIG-FIVE PERSONALITY FACTORS AS PREDICTORS OF OBSESSION-COMPULSION AMONG A SAMPLE OF UNIVERSITY STUDENTS FROM SUDAN

The aim of the present study was to explore the associations between the Big-Five (B-F) personality factors and obsession-compulsion. A sample of Khartoum University students was recruited (N = 547). They responded to the Arabic Big-Five Personality Inventory and the Arabic Scale of Obsession-Compulsion-Revised. Results indicated that women obtained a significantly higher mean scores than did men on agreeableness, neuroticism, and extraversion, but the size effects were small. Obsession-compulsion was significantly and positively associated with neuroticism, agreeableness, openness, conscientiousness (in men), neuroticism, and agreeableness (in women). Principal components analysis extracted two high-loaded components in both sexes and labeled: “Stable personality”, and “Psychological disorder”. Regression analysis indicated that the predictors of obsession-compulsion were neuroticism, openness (in men, R2 = .18), neuroticism, conscientiousness, and openness (in women, R2 = .23). These results refer to the associations between the B-F and obsession compulsion, particularly neuroticism. In psychotherapy, the amelioration of neuroticism may reduce symptoms of obsession-compulsion

Spatially and genetically distinct African trypanosome virulence variants defined by host interferon-g response

We describe 2 spatially distinct foci of human African trypansomiasis in eastern Uganda. The Tororo and Soroti foci of <i>Trypanosoma brucei rhodesiense</i> infection were genetically distinct as characterized by 6 microsatellite and 1 minisatellite polymorphic markers and were characterized by differences in disease progression and host-immune response. In particular, infections with the Tororo genotype exhibited an increased frequency of progression to and severity of the meningoencephalitic stage and higher plasma interferon (IFN)–γ concentration, compared with those with the Soroti genotype. We propose that the magnitude of the systemic IFN-γ response determines the time at which infected individuals develop central nervous system infection and that this is consistent with the recently described role of IFN-γ in facilitating blood-brain barrier transmigration of trypanosomes in an experimental model of infection. The identification of trypanosome isolates with differing disease progression phenotypes provides the first field-based genetic evidence for virulence variants in T. <i>brucei rhodesiense</i>

Using (1,3)-β-D-glucan concentrations in serum to monitor the response of azole therapy in patients with eumycetoma caused by Madurella mycetomatis

Introduction: (1,3)-β-D-glucan is a panfungal biomarker secreted by many fungi, including Madurella mycetomatis, the main causative agent of eumycetoma. Previously we demonstrated that (1,3)-β-D-glucan was present in serum of patients with eumycetoma. However, the use of (1,3)-β-D-glucan to monitor treatment responses in patients with eumycetoma has not been evaluated. Materials and Methods: In this study, we measured (1,3)-β-D-glucan concentrations in serum with the WAKO (1,3)-β-D-glucan assay in 104 patients with eumycetoma treated with either 400 mg itraconazole daily, or 200 mg or 300 mg fosravuconazole weekly. Serial serum (1,3)-β-D-glucan concentrations were measured at seven different timepoints. Any correlation between initial and final (1,3)-β-D-glucan concentrations and clinical outcome was evaluated. Results: The concentration of (1,3)-β-D-glucan was obtained in a total of 654 serum samples. Before treatment, the average (1,3)-β-D-glucan concentration was 22.86 pg/mL. During the first 6 months of treatment, this concentration remained stable. (1,3)-β-D-glucan concentrations significantly dropped after surgery to 8.56 pg/mL. After treatment was stopped, there was clinical evidence of recurrence in 18 patients. Seven of these 18 patients had a (1,3)-β-D-glucan concentration above the 5.5 pg/mL cut-off value for positivity, while in the remaining 11 patients, (1,3)-β-D-glucan concentrations were below the cut-off value. This resulted in a sensitivity of 38.9% and specificity of 75.0%. A correlation between lesion size and (1,3)-β-D-glucan concentration was noted. Conclusion: Although in general (1,3)-β-D-glucan concentrations can be measured in the serum of patients with eumycetoma during treatment, a sharp decrease in β-glucan concentration was only noted after surgery and not during or after antimicrobial treatment. (1,3)-β-D-glucan concentrations were not predictive for recurrence and seem to have no value in determining treatment response to azoles in patients with eumycetoma.</p

The Impact of Alexithymia on Self-Compassion through Cultural and Gender Factors: A Study across Culture in Seven Arab Countries

ملخص: هدفت الدراسة للتعرف على نسبة انتشار الألكسثيميا، وطبيعة العلاقة بينها وبين الشفقة بالذات، ومعرفة التباين لكل من الألكسثيميا والثقافة والجنس والتفاعل بينهم على أبعاد الشفقة بالذات في عدد من المجتمعات العربية (الكويت، العراق، السودان، البحرين، اليمن، المغرب، فلسطين). ولتحقيق هدف الدراسة استخدم المنهج الوصفي الارتباطي، تكونت العينة من (N= 2265)، تراوحت أعمارهم بين (18-60) عاماً، بمتوسط عمري (27.28) عاماً، منهم (992 ذكراً)، طبق عليهم مقياس تورنتو للألكسثيميا (ترجمة العيدان، 2019a)، ومقياس الشفقة بالذات إعداد نيف (Neff, 2003 a). وأظهرت النتائج اختلاف نسبة انتشار الألكسثيميا وتراوحت بين (26.2 % - 49 %)، وفي العينة الكلية بلغت (36.7 %)، وكذلك تباينت العلاقات بين الألكسثيميا والشفقة بالذات، وأظهرت العينة الكلية وجود علاقة موجبة بين الألكسثيميا والحكم على الذات، والعزلة، والإفراط في التوحد. وكان للألكسثيميا تأثير على الأبعاد السلبية للشفقة بالذات، وكان الألكسثيميين أعلى تأثير في الحكم على الذات وفي العزلة، والإفراط في التوحد، وكان حجم الأثر الأكبر هو تأثير الألكسثيميا في الحكم على الذات حيث كان يُعزى للفروق على الألكسثيميا ما نسبته (13.4%)، ولم تكن هذه الفروق بمعزل عن تأثير الثقافة حيث أظهرت النتائج تفاعلاً لعاملي الألكسثيميا والثقافة في تباين أبعاد الشفقة بالذات.Abstract: The study aimed to identify the prevalence of alexithymia, the nature of the relationship between it and self-compassion, and the differences between alexithymia, culture, gender, and the interaction between them on the dimensions of self-compassion in seven Arab societies, to achieve the aim of the study, the descriptive, correlational approach was used.&nbsp; The sample consisted of (N= 2265); their ages ranged between (18-60) years, who were applied to the Toronto Alexithymia Scale. and the Self Compassion Scale.The results showed a difference in the prevalence of alexithymia, which ranged between (26.2% - 49%), and it reached (36.7%) in the total sample, Moreover, the relationships between alexithymia and self-compassion also varied, and the total sample showed a positive relationship between alexithymia and self-judgment, isolation, and Over-identification. Furthermore, alexithymia influenced the dimensions of self-compassion, especially the negative dimensions, and alexithymic people were higher in self-judgment, isolation, and self-identification. The largest effect size was the effect of alexithymia on self-judgment, as the differences were attributed to alexithymia at a rate of (13.4%), and these differences were not isolated from the influence of culture, as the results showed an interaction of the factors of alexithymia and culture in varying the dimensions of self-compassion

Impact of Ramadan focused education program on hypoglycemic risk and metabolic control for patients with type 2 diabetess

Background: Fasting during the month of Ramadan could lead to acute complications and increased hypoglycemic risk of patients with type 2 diabetes. Therefore, diabetes is one of the diseases that need careful observation and special considerations during Ramadan including patients’ education and counseling. Objectives: To evaluate the impact of Ramadan focused education program on acute complications and biomedical parameters. Methods: A prospective nonrandomized interventional controlled design was run on three phases: before, during, and after Ramadan on 262 type 2 diabetes patients. The intervention group (n=140) received focused individualized diabetic education sessions and antidiabetic medications adjustment before and after Ramadan, while the control group (n=122) received standard diabetic care. A validated hypoglycemia questionnaire was used in both groups to assess the change of the risk. Patients were advised to adjust the dosage and timing of antidiabetic agents according to the recommendations for management of diabetes during Ramadan. Primary outcomes were postintervention change of hypoglycemia score and HbA1c over 6-month follow-up. Data were presented as mean ± standard deviation. HbA1c was expressed in percentage. Results: The hypoglycemic scores before, during, and after Ramadan were 14.21±8.50, 6.36±6.17, and 5.44±5.55 in the intervention group, respectively (P,0.001) and 14.01±5.10, 13.46±5.30, and 9.27±4.65 in the control group, respectively (P,0.001). HbA1c levels were 9.79±1.89, 8.26±1.54, and 8.52±1.61 before, during, and after Ramadan in the intervention group, respectively (P,0.001), and 10.04±1.47, 9.54±1.38, and 9.59±1.79 in the control group, respectively (P,0.001). Post-Ramadan reductions of HbA1c and hypoglycemic scores were significantly higher in the intervention group (-13.0% vs -4.5%, P=0.004 for HbA1c and -61.7% vs -33.8%, P,0.001 for hypoglycemic score). Low-density lipoprotein cholesterol improved in the intervention group from 2.41±0.91 mmol/L before Ramadan to 2.28±0.68 mmol/L after Ramadan (P,0.001). No statistically significant effects were observed on blood pressure or body weight in the intervention group. Also, no change was observed in the control group. Conclusion: Ramadan educational program had a positive impact with reduction of hypoglycemic risk, HbA1c, and low-density lipoprotein cholesterol. Therefore, it could be recommended for patients with increased risk of hypoglycemia during Ramadan fasting

Cross-cultural comparison of mental illness stigma and help-seeking attitudes: a multinational population-based study from 16 Arab countries and 10,036 individuals

BackgroundThere is evidence that culture deeply affects beliefs about mental illnesses\u27 causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking.MethodsWe carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public.ResultsMore than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p \u3c .001), knowledge (F = 88.7, p \u3c .001), and help-seeking attitudes (F = 32.4, p \u3c .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants.ConclusionInterventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations

Mycobacterium avium subsp. paratuberculosis and microbiome profile of patients in a referral gastrointestinal diseases centre in the Sudan

Mycobacterium avium subsp. paratuberculosis (MAP) causes Johne’s disease in animals with zoonotic potential; it has been linked to many chronic diseases in humans, especially gastrointestinal diseases (GID). MAP has been extensively studied in Europe and America, but little reports were published from Africa. Sudan is a unique country with close contact between humans and livestock. Despite such interaction, the one health concept is neglected in dealing with cases of humans with GID. In this study, patients admitted to the reference GID hospital in the Sudan over a period of 8 months were screened for presence of MAP in their faeces or colonic biopsies. A total of 86 patients were recruited for this study, but only 67 were screened for MAP, as 19 did not provide the necessary samples for analysis. Both real-time PCR and culture were used to detect MAP in the collected samples and the microbial diversity in patients´ faecal samples was investigated using 16S rDNA nanopore sequencing. In total, 27 (40.3%) patients were MAP positive: they were 15 males and 12 females, of ages between 21 and 80 years. Logistic regression analysis revealed no statistical significance for all tested variables in MAP positive patients (occupation, gender, contact with animal, milk consumption, chronic disease, etc.). A unique microbiome profile of MAP-positive patients in comparison to MAP-negative was found. These findings suggest that a considerable proportion of the population could be MAP infected or carriers. Therefore, increase awareness at community level is urgently needed to decrease the risk of MAP at human/animal interface. This study represents the first report of MAP in humans in the Sudan; nevertheless, a better view of the situation of MAP in humans in the country requires a larger study including patients with other conditions.Additional co-authors: Ahmad Amanzada, Kamal H. Eltom , ElSagad Eltaye