Gower sign positive muscle weakness in a patient with short stature and hypophosphatemia

A 17-year-old Sudanese patient presented with short stature, generalized body aches, and proximal muscle weakness. He was seen by two orthopedic surgeons and an adult neurologist and misdiagnosed as having benign bone cysts, osteomalacia and Duchenne muscular dystrophy. Infact, he was suffering from severe hypophosphatemia, which manifest by unusual presentation. The diagnostic pitfalls are explained and the importance of urinalysis and measurement of bone minerals are emphasized.Keywords: Renal tubular acidosis, Fanconi syndrome, Rickets

Effects of different levels of sugar beet roots based concentrates on the performance of Tagger male kids

    High meat demand in the Sudan enhanced improvement of goat meat production. Tagger is a promising meat breed due to good conformation and high meat quality. Nutrition is a main constraint for goat meat production. Sugar beet is introduced into the Gezira State with no information on effects of dried sugar beet roots (DSBR) based concentrates level on Tagger kids performance, carcass characteristics and meat composition. Twelve Tagger males of 6 months old were housed in individual pens, divided into 3 groups, each with 4 animals and allocated at random to the experimental diets. They were weighed weekly for 8 weeks with a two weeks preliminary period. They were fed groundnut haulm (GNH) ad lib. in two equal meals at 8.0 am and 4.0 pm and refusals were collected and weighed daily. The animals were fed different levels of DSBR based concentrates: 0 (control), 150g and 300g, in two equal parts before GNH meals. The concentrates contained 68% DSBR,15% groundnut cakes, 15% sunflower cakes, 1% salt and 1% oyster shell. Samples of feeds and refusals were stored for laboratory analysis.  Resultd showed that groundnut haulm (30% CP, 8.8% CF, 4.8% ash and 48.2% NFE) had better proximate analysis than refusals which generally improved with concentrates levels. Dried sugar beet had 12.9% CP, 11.0% CF and 59.25% NFE and the concentrates had 42.25% CP, 2.0% CF and 49.5% NFE. Overall mean BW generally increased with concentrates level (10.78, 10.9 and 12.19kg at 0, 150 and 300g, respectively), but  not significantly different. Overall mean daily feed intakes varied with concentrates level and were 1550.89, 1187.46 and 1545.67g at 0, 150 and 300g concentrates, respectively, and were significantly least in animals fed 150g concentrates. Weekly weight gain generally increased with concentrates level in all weeks and was highest in animals fed 150g concentrates with no significant effects for concentrates level. It was 0.55, 0.68 and 0.60 kg at 0, 150 and 300g concentrates, respectively. It is recommended to use DSBR based concentrates in fattening Tagger kids.     حفز ارتفاع الطلب  على اللحوم وأسعارها في السودان تحسين لحوم الماعز. تعتبر التقر سلالة واعدة لإنتاج اللحوم لجودة القوام ونوعية اللحم.  إلا أن التغذية من المعوقات الرئيسة لإنتاج لحوم الماعز.  أدخل بنجر السكر لولاية الجزيرة ولا تتوفر معلومات عن أثر مستوى جذر البنجر الجاف) ج ب ج (على أداء جديان التقر وصفات الذبيحة  وتركيب اللحم.  وضعت 12 من ذكور جديان التقر بعمر 6 أشهر في حظائر فردية  وقسمت الى 3 مجموعات بكل منها 4 حيوانات  ووزعت عشوائيا على أعلاف الدراسة. وزنت الحيوانات أسبوعيا لمدة 8 أسابيع منها أسبوعين فترة إعدادية. أعلفت الحيوانات تبن الفول السوداني )ت ف س) حسب الرغبة في وجبتين متساويتين عند الثامنة صباحا والرابعة مساء وجمع ووزن العلف المتبقي.  كما أعلفت الحيوانات مستويات مختلفة من عليقة مركزة ترتكز على )ج ب ج  (عند صفر( الشاهد), 150 و300جم في جزئين متساويين  قبل وجبتي ت ف س. احتوت العليقة المركزة على 68% ج ب ج و15%  امباز فول سوداني و15%  تبن زهرة الشمس و1% ملح و 1% صدف  حفظت عينات من  الأعلاف والعلف المتبقي للتحليل المعملي.  حُللت المعلومات إحصائيا باستخدام تحليل التباين واستخدم اختبار دنكن لفصل اختلافات المتوسطات. كان  ت ف س (  30% بروتين خام ، 8.85 ألياف خام، 4.8% رماد و 48.2% جزء خالي من النتروجين) أحسن في التحليل التقريبي من المتبق.والذي تحسنت نوعيته بارتفاع مستوى العليقة المركزة. كان تركيب  ج ب ج 12.95 % بروتين خام ، 11% الياف خام و 59.25% جزء خالي من النتروجين .وتركيب العليقة المركزة  42.25 % بروتين خام ، 2% ألياف خام و 49.5% جزء خالي من النتروجين .  زاد متوسط الوزن الكلى مع زيادة العليقة المركزة (10.78 ،  10.9 و 12.19عند صفر و 150 و 300 جم عليقة مركزة على التوالي بدون فروقات معنوية . (P>.05)  تباين متوسط المتناول من العلف تبعاً لمستوي المركزات وكان 1550.89 و 1187.46 و 1545.67 جم عند صفر و 150 و300 جم عليقة مركزة ، علي التوالي وكان أقل معنوياً للحيوانات التي غُذيت علي  150عليقة مركزة.  تباينت زيادة الوزن الأسبوعي بزيادة مستوي العليقة المركزة في كل الأسابيع وكانت الأعلى للحيوانات عند 150 جم بدون زيادة معنوية. وكانت 0.55 و0.68 و 0.60 كجم عند صفر و 150 و300 جم عليقة مركزة، علي التوالي. يوصي باستخدام علائق جذور بنجر السكر المجففة لتسمين جديان التقر

Supplementation of fermented sorghum bread (kisra) with dehulled and defatted sesame flour

    In this study, dehulled sesame seeds obtained from Mamoun Elberier factory were defatted by solvent extraction to produce a dehulled and defatted sesame flour (DDSF). Proximate analyses were determined on both the dehulled sesame flour and dehulled and defatted sesame flour. The results indicated that there was an increase in the contents of protein, moisture, fiber and carbohydrates due to the defatting process. Flour obtained from the dehulled and defatted sesame seed was used to supplement staple Sudanese baked product sorghum kisra, in the ratios of 10%, 20% and 30%. The various replacement ratios resulted in an increase in the protein content of the kisra from 12.25% in control kisra to about 15.75%, 19.49%, and 23.20%, respectively. The above replacement ratios also resulted in a concomitant increase in the in-vitro protein digestibility of kisra breads. The sensory analysis indicated that there were no significant difference between kisra bread made from the various blends of sorghum and DDSF. However, panelists gave higher scores to the 10% sesame/sorghum supplemented kisra than the kisra made from the other ratios. Nutritional value of kisra can be enhanced by the addition of DDSF at a level of up to 30%

Some characteristics of the Sudanese bread (Kisra) supplement with fenugreek (Trigonella foenum-graecum L)

     In this study the chemical composition of two fenugreek seed types known locally as Sudanese and Ethiopian' types and sorghum kisras supplemented with 5%, 10% and 20% flour of the two fenugreek types after removal of the bitter taste, was determined* The two fenugreek seed types had shown slightly small differences in most of their chemical components, however, the Ethiopian type had slightly more protein (26.4+0.4 %) than that of the Sudanese type (25.5± 0.07 %). On the other hand, the Sudanese type contained more mucilage (23.5±0.04 %) than that of the Ethiopian type (22.6±0.010/0). The most significant effect of kisra supplementation was the increase in good quality protein by a range of 31-66%. It increased from 11.20% in the control kisra to the range of 14.70-18.64%. The crude fibre% of the control kisra (3.40%) increased in the supplemented kisras to the range of 4.54-5.30%. The ash% decreased from 2.42% in the control kisra, to the range of 2.20 - le20% in the supplemented kisras. The sensory analysis indicated that the fenugreek supplemented kisra was accepted by the panelists at the 5% level of fenugreek seed flour supplementation. The overall acceptance level of the different samples decreased with the increase in fenugreek seed flour used in supplementation

Chemical and Microbiological Characteristics of Fermented Milk Product, Mish

Abstract This study aimed to assess the quality aspects of commercial mish samples collected from Khartoum State through determination of the chemical and the microbiological characteristics, in addition to the production of mish at laboratory level from cow's milk (C) and goat's milk (G) and assessment of the product quality. The chemical analyses of both commerical and laboratory made mish samples revealed a range of pH: 4.4 -4.49, acidity: 1.5 -2.0, total soilds: 33.38 -37.21, soilds non-fat: 25.3 -29.9, fats: 6.2 -7.13, protein: 7.0 -8.03, ash: 1.41 -1.99, and moisture: 75.95 -83.78. The micobiological analysis indicated that the total count of the commercial samples ranged between 3.98-4.1 log 10 cfu/ml, while the laboratory made mish from goat milk (LMMG) and cow milk (LMMC) recorded 14.5 log 10 cfu/ml and 13.5 log 10 cfu/ml, respectively. The yeast count in the commercial mish samples ranged between 3.9-3.96 log 10 cfu/ml, while they were 3.8 log 10 cfu/ml in LMMG and 4.0 log 10 cfu/ml in in all tested samples. The laboratory made mish samples were highly accepted by the panelists

Production of Self-healing Concrete using Gum Arabic for Immobilizing of Bacterial Spores on Sand

This paper studies the feasibility of producing self-healing concrete by immobilization of bacteria on the sand. In this study, the Gum Arabic (Acacia Senegal) was used to immobilize bacterial spores and its nutrient (Calcium lactate) on sand surface as a novel technique. Due to its availability and environment-friendly character, Bacillus subtilis bacteria have been selected and prepared. To achieve the aim of this study, three concrete mixes were made with 10%, 5%, and 2.5% of gum-capsulated sand with bacteria. The ability of self-healing of cracks was monitored using stereomicroscope and digital image camera. The experiments have shown that the proposed technique is efficient in healing of cracks without impairing the prisms' strength for mixes with 2.5% and 5% of gum-capsulated sand with bacteria. The results give a proof-of-concept to use Gum Arabic as an adhesion to immoblize the bacteria and its nutrient on sand to produce self-healing concrete

Basal-Like Phenotype in a Breast Carcinoma Case Series from Sudan: Prevalence and Clinical/Pathological Correlations

Basal-like breast cancer, an aggressive subtype associated with high grade, poor prognosis, and younger age, is reported frequently in Africa. We analyzed the expression of the basal cytokeratins (CKs) 5/6 and 17 in a case series from Central Sudan and investigated correlations among basal CK status, ER, PgR, and Her-2/neu, and individual/clinicopathological data. Of 113 primary breast cancers 26 (23%), 38 (34%), and 46 (41%) were, respectively, positive for CK5/6, CK17, and combined basal CKs (CK5/6 and/or CK17). Combined basal CK+ status was associated with higher grade (P < .03) and inversely correlated with ER (P < .002), PgR (P = .004) and combined ER and/or PgR (P < .0002). Two clusters based on all tested markers were generated by hierarchical cluster analysis and k-mean clustering: I: designated “hormone receptors positive/luminal-like” and II: designated “hormone receptors negative”, including both basal-like and Her-2/neu+ tumors. The most important factors for dataset variance were ER status, followed by PgR, CK17, and CK5/6 statuses. Overall basal CKs were expressed in a fraction of cases comparable to that reported for East and West African case series. Lack of associations with age and tumor size may represent a special feature of basal-like breast cancer in Sudan

Vitamin D and subsequent all-age and premature mortality: a systematic review

&lt;br&gt;Background: All-cause mortality in the population &#60; 65 years is 30% higher in Glasgow than in equally deprived Liverpool and Manchester. We investigated a hypothesis that low vitamin D in this population may be associated with premature mortality via a systematic review and meta-analysis.&lt;/br&gt; &lt;br&gt;Methods: Medline, EMBASE, Web of Science, the Cochrane Library and grey literature sources were searched until February 2012 for relevant studies. Summary statistics were combined in an age-stratified meta-analysis.&lt;/br&gt; &lt;br&gt;Results: Nine studies were included in the meta-analysis, representing 24,297 participants, 5,324 of whom died during follow-up. The pooled hazard ratio for low compared to high vitamin D demonstrated a significant inverse association (HR 1.19, 95% CI 1.12-1.27) between vitamin D levels and all-cause mortality after adjustment for available confounders. In an age-stratified meta-analysis, the hazard ratio for older participants was 1.25 (95% CI 1.14-1.36) and for younger participants 1.12 (95% CI 1.01-1.24).&lt;/br&gt; &lt;br&gt;Conclusions: Low vitamin D status is inversely associated with all-cause mortality but the risk is higher amongst older individuals and the relationship is prone to residual confounding. Further studies investigating the association between vitamin D deficiency and all-cause mortality in younger adults with adjustment for all important confounders (or using randomised trials of supplementation) are required to clarify this relationship.&lt;/br&gt

Gum Arabic in renal disease (GARDS Study): Clinical evidence of dietary supplementation impact on progression of renal dysfunction

Administration of Gum Arabic (GA) was associated with an increase in estimated Glomerular filtration rate (eGFR) at three months (pre 24.64 ± 8.89 vs 26.20 ± 10.1p = 0.02). Subsequently there was no significant fall in eGFR. This translated to positive change in Δ eGFR within quarter at three months, (Δ eGFR 4.89 ml/min/year p=<0.001 vs pre) and six months (Δ eGFR 0.79 ml/min/year, p < 0.001 vs pre) compared to pre-intervention values. At 9 and 12 months although the mean Δ eGFR in quarter was negative, this rate of decline in renal function remained significantly less than prior to intervention (9 months Δ eGFR −1.27 ml/min/year, p= <0.001 vs pre, 12 months delta Δ eGFR −1.54 ml/min/year, p < 0.001 vs pre). Similarly, mean reciprocal creatinine, declined by 11% in the pre-intervention period but was no different to the pre-intervention values for the duration of intervention. In conclusion oral administration of Gum Arabic attenuates the rate of decline in renal function

Treatment-Based Strategy for the Management of Post-Kala-Azar Dermal Leishmaniasis Patients in the Sudan

Post-kala-azar dermal leishmaniasis (PKDL) is a dermatosis that affects more than 50% of successfully treated visceral leishmaniasis (VL) patients in Sudan. PKDL is considered an important reservoir for the parasite and its treatment may help in the control of VL. Currently, treatment is mainly with sodium stibogluconate (SSG), an expensive and fairly toxic drug and without universally in treatment protocols used. A literature review, a consensus of a panel of experts, and unpublished data formed the basis for the development of guidelines for the treatment of PKDL in the Sudan. Six treatment modalities were evaluated. Experts were asked to justify their choices based on their experience regarding of drug safety, efficacy, availability, and cost. The consensus was defined by assigning a categorical rank (first line, second line, third line) to each option. Regarding the use of AmBisome the presence of the drug in the skin was confirmed in smears from PKDL lesions. Recommendations: AmBisome at 2.5 mg/kg/day/20 days or SSG at 20 mg/kg/day/40 days plus four/weekly intradermal injection of alum-precipitated autoclave L. major vaccine are suggested as first-and second-treatment options for PKDL in the Sudan, respectively. SSG at 20 mg/Kg/day/60 or more days can be used if other options are not available