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

Response of Banana "Williams Hybrid" to Nitrogen, Phosphorus and Potassium Fertilization

Field experiments were conducted at the National Institute for Promotion of Horticultural Exports (NIPHE) research farm during the period of 2001 to 2002 to determine the effects of nitrogen, phosphorus and potassium levels on growth parameters, earliness, nutrient uptake, yield and yield components of "William's hybrid" banana cultivar. Treatments included 5 N levels (0, 69, 138, 207 and 276g N/mat/year), 2 P levels (0 and 20 g P/mat/year) and 2 K levels (0 and 41 g K/mat/year) . The treatments were arranged in a randomized complete block design with 3 replications. Banana growth, yield and yield components were significantly increased by N and K application. The highest vegetative growth parameters, yield and yield components were obtained with the application of 207 g N/mat/year in combination with 41 g K/mat/year. Application of N in combination with K also resulted in a significant reduction in the period from plant-ing to shooting and from shooting to fruit maturation. The shortest number of days to shooting were obtained with the application of 276 g N/mat/year. Application of N, P and K also resulted in increased leaf N, P and K contents. Application of P alone or in combinations with N and K had no significant effects on growth or yield parameters

Effect of Antioxidants and Dehanding Methods under Different Temperature Levels on the Control of Banana Crown Browning

Two experiments were conducted at the National Institute for the Promotion of Horticultural Exports, University of Gezira, Sudan, during the period from 2000 to 2001 to investigate the effects of dehanding methods and antioxidants under two temperature levels on the control of banana crown browning. Dehanding methods included separation of hands under water or in air and cutting the hands using a knife under water or in air. The antioxidants were thiourea (1%), aluminum potassium sulfate (1%), ascorbic acid (150 ppm) and wax dissolved in petroleum ether. Dehanding by separation significantly reduced crown browning as compared to the other methods. The best antioxidants in reducing crown browning were thiourea and potassium aluminum sulfate which are sulfur-containing compounds and had an antioxidant activity. Banana hands stored at 14C˚ had significantly less crown browning as compared to those kept at 35C0 because the lower temperature reduced the activity of polyphenoloxidase enzyme which is responsible for banana crown browning. The interaction effects between antioxidants and temperature showed that the antioxidants followed the same trend mentioned previously within each temperature level, but were more effective in reducing banana crown browning at 140C

Current status of tomato greenhouse production in Khartoum and Gezira States, Sudan.

Tomato production under protected cultivation has increased consistently in recent decades in the Sudan. The objective of this study was to investigate the current situation of tomato cultural practices in existing greenhouses in Khartoum and Gezira States. A survey was carried out using a questionnaire and interviews with greenhouse owners in Khartoum and Gezira States. Khartoum and Gezira States have about 68 greenhouse projects, 33 of them were selected for the study. Data were collected during 2013 and analyzed using statistical package for social sciences (SPSS). Results indicated that a large number of introduced tomato cultivars were used for production and most of greenhouse farmers (48.5%) sow tomato seeds in mid-February. The majority of farmers (63.6%) grow tomato in high plant density (30cm). More than half of greenhouses (75.8 %) had no specific fertilizer programs. Most of the greenhouse farmers (90.9 %) prune weekly. All greenhouse farmers used pesticides for pest control. Our observations indicated that most of the growers failed to produce summer tomato. Accordingly, further research in tomato greenhouse production is needed

Status of greenhouses in Khartoum and Gezira States, Sudan

   Greenhouse technology facilitates the cultivation of most horticultural crops in any region of the world, provided that the greenhouse is properly designed and equipped to control environmental conditions. The objective of this study was to investigate the characteristics of greenhouses in Khartoum and Gezira States, Sudan, and show their drawbacks and disadvantages.  A survey was carried out using a questionnaire and interviews with greenhouse owners in Khartoum and Gezira States. Khartoum and Gezira States have about 68 greenhouse projects, 33 of them were selected for the study. The data were collected during 2013 and were analyzed using statistical package for social sciences (SPSS) computer program. Results showed that 69.7% of greenhouses were privately owned and the vast majority of greenhouses were used to produce vegetable crops or seedlings. Results indicated that most of the greenhouses designs are not suited to the hot arid tropics of the Sudan. More than half of greenhouses had the arched system, most of them were covered by polyethylene, 69.7% of greenhouses were constructed in a single span, 72.7% had a single door, 76.3% of greenhouses had a height between 2.5 m to 3 m and 42.6% of them were 40 m long. Accordingly, an ideal greenhouse design is needed in which all the drawbacks and shortcomings are corrected to suit the arid conditions of central Sudan

Sudanese Medical Students and Scientific Research

Background: Most of developing countries face problems in assessment of their public health practices. Gain of this knowledge is orchestrated by  research. Medical students can play an essential role in improving public database.Objective: to explore knowledge, attitude and skills of medical students in the Faculty of Medicine and Health Sciences (FMHS), Omdurman Islamic University (OIU) towards research.Materials and Methods: This is a descriptive, analytical, cross-sectional, institution-based study. A total of 442 students, equally from each batch participated in the study. Equal numbers of male andfemale were considered to eliminate gender and seniority bias. Structured pretested questionnaire was used for data collection. Data collected were fed to Statistical Package for Social Sciences(SPSS) version 15. Means, standard deviation and correlations were done where appropriate. Statistical  significance was taken at P =0.05.Results: The mean knowledge score was 37% and attitude was positive in 77.1% of the students. Only 18.3% had attended research methodology workshop. The rate of internet navigation is directly proportional to the social class. Only 14.7% knew the engines used for finding medical literature.Conclusion: The low knowledge score is due to lack of application of research in the academic curriculum; however, the students have a fairly positive attitude. The knowledge is expected to improve with the intended policy to include practical research in the curriculum.Key Words: Public health, academic curriculum, Suda

Renal cell carcinoma in children: Case report and literature review

Renal cell carcinoma is infrequent in children; consequently it is important to communicate its diagnosis and follow up. The behaviour of this type of tumor is better characterized in adults and in this setting the treatment of choice is surgical resection. However, the place of chemo- and radiotherapy has not been well defined. Here, we present a 9-year-old boy with renal cell carcinoma demonstrating only hematuria without any pathological physical examination findings. The mass was described by abdominal ultrasonography and computed tomography in the left kidney. After the left nephroureterectomy, the patient was given no adjuvant therapy

Fatty Acid Ethyl Esters Induce Intestinal Epithelial Barrier Dysfunction via a Reactive Oxygen Species-Dependent Mechanism in a Three-Dimensional Cell Culture Model

Background & Aims: Evidence is accumulating that ethanol and its oxidative metabolite, acetaldehyde, can disrupt intestinal epithelial integrity, an important factor contributing to ethanol-induced liver injury. However, ethanol can also be metabolized non-oxidatively generating phosphatidylethanol and fatty acid ethyl esters (FAEEs). This study aims to investigate the effects of FAEEs on barrier function, and to explore the role of oxidative stress as possible mechanism. Methods: Epithelial permeability was assessed by paracellular flux of fluorescein isothiocyanate-conjugated dextran using live cell imaging. Cell integrity was evaluated by lactate dehydrogenase release. Localization and protein levels of ZO-1 and occludin were analyzed by immunofluorescence and cell-based ELISA, respectively. Intracellular oxidative stress and cellular ATP levels were measured by dichlorofluorescein and luciferase driven bioluminescence, respectively. Results: In vitro, ethyl oleate and ethyl palmitate dose dependently increased permeability associated with disruption and decreased ZO-1 and occludin protein levels, respectively, and increased intracellular oxidative stress without compromising cell viability. These effects could partially be attenuated by pretreatment with the antioxidant, resveratrol, pointing to the role of oxidative stress in the FAEEs-induced intestinal barrier dysfunction. Conclusions: These findings show that FAEEs can induce intestinal barrier dysfunction by disrupting the tight junctions, most likely via reactive oxygen species-dependent mechanism

Novel drug targets in cell wall biosynthesis exploited by gene disruption in Pseudomonas aeruginosa

© 2017 Elamin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For clinicians, Pseudomonas aeruginosa is a nightmare pathogen that is one of the top three causes of opportunistic human infections. Therapy of P. aeruginosa infections is complicated due to its natural high intrinsic resistance to antibiotics. Active efflux and decreased uptake of drugs due to cell wall/membrane permeability appear to be important issues in the acquired antibiotic tolerance mechanisms. Bacterial cell wall biosynthesis enzymes have been shown to be essential for pathogenicity of Gram-negative bacteria. However, the role of these targets in virulence has not been identified in P. aeruginosa. Here, we report knockout (k.o) mutants of six cell wall biosynthesis targets (murA, PA4450; murD, PA4414; murF, PA4416; ppiB, PA1793; rmlA, PA5163; waaA, PA4988) in P. aeruginosa PAO1, and characterized these in order to find out whether these genes and their products contribute to pathogenicity and virulence of P. aeruginosa. Except waaA k.o, deletion of cell wall biosynthesis targets significantly reduced growth rate in minimal medium compared to the parent strain. The k.o mutants showed exciting changes in cell morphology and colonial architectures. Remarkably, ΔmurF cells became grossly enlarged. Moreover, the mutants were also attenuated in vivo in a mouse infection model except ΔmurF and ΔwaaA and proved to be more sensitive to macrophage-mediated killing than the wild-type strain. Interestingly, the deletion of the murA gene resulted in loss of virulence activity in mice, and the virulence was restored in a plant model by unknown mechanism. This study demonstrates that cell wall targets contribute significantly to intracellular survival, in vivo growth, and pathogenesis of P. aeruginosa. In conclusion, these findings establish a link between cell wall targets and virulence of P. aeruginosa and thus may lead to development of novel drugs for the treatment of P. aeruginosa infection