Cancer management in Sudan: Current status and future perspectives

Introduction: Sudan is one of the developing countries that face a great challenge with cancer management. About 5700 cases had been seen during year 2007 in Radiation and Isotope Center- Khartoum (RICK) and Institute of Nuclear medicine, Molecular biology, and Oncology (INMO) Wadmedani which are the only cancer centers in Sudan.Purpose: Aim of this work is to highlight the difficulties of cancer management in Sudan and to propose possible solutions.Methods: This paper evaluates the current situation of cancer management in Sudan through reviewing of data available in cancer centers and reports from the Sudan national bureau of statistic. Suggestions are also made for cancer control plan in Sudan having the current situation in mind and guided by the published international data on cancer control.Results: The preliminary analysis of the available data reveals that Sudan has very limited resources available to deal with cancer and the service provided is not evenly distributed.Conclusion: Establishment of new centers is extremely needed with special attention to good distribution of services. To achieve such a goal training of more staff and upgrading of the existing centers is mandatory to manage all types of cancer. Cancer registry is the right way to plan for cancer control in Sudan.Keywords: Nuclear medicine, radiation, oncologis

Impact of Body Mass Index on Vascular Calcification and Pericardial Fat Volume Among Patients with Suspected Coronary Artery Disease

Objectives: This study aimed to assess the effect of body mass index (BMI) on the relationship between pericardial fat volume (PFV), aortic root calcification (ARC) and coronary artery calcification (CAC) among patients with suspected coronary artery disease (CAD). Methods: This cross-sectional study took place between January and December 2014 at the Kufa University Teaching Hospital, Najaf, Iraq. A total of 130 consecutive patients with an intermediate pretest probability of ischaemic heart disease who underwent 64-slice multidetector computed tomography (CT) angiography during the study period were recruited. Of these, 111 were included in the study and divided into groups according to BMI. Imaging markers were measured on CT angiography. Results: A total of 28 patients were obese, while 42 and 41 were overweight and normal weight, respectively. The median PFV, CAC and ARC was 109 cm3 (interquartile range [IQR]: 52–176 cm3), 0 Agatston score (IQR: 0–52 Agatston score) and 0 Agatston score (IQR: 0–15 Agatston score), respectively, in the normal weight group in comparison to 79 cm3 (IQR: 43–138 cm3), 0 Agatston score (IQR: 0–54 Agatston score) and 0 Agatston score (IQR: 0–0 Agatston score), respectively, in the obese group. Significant correlations were observed between PFV and CAC (r2 = 0.22; P = 0.002) and ARC and CAC (r2 = 0.37; P <0.001) in the normal weight group. However, no significant correlations were observed for obese and overweight patients. Conclusion: These findings indicate that BMI may not be an accurate tool for measuring adiposity or assessing subclinical coronary atherosclerosis in patients with suspected CAD

POLYMORPHISMS OF PFCRT AND PFMDR-1 GENES AND CHLOROQUINE RESISTANCE OF P. FALCIPARUM IN WAD MEDANI (CENTRAL SUDAN)

Introduction: Malaria parasite resistant to Chloroquine poses severe and increasing health problems in tropical countries. Monitoring the drug resistance by implementing the molecular markers may be essential to overcome the problem, therefore this study aims to assess the Chloroquine resistance of Plasmodium Falciparum parasite in central Sudan, using molecular markers. Methods: One hundred and seventy six patients were confirmed P. falciparaum positive. Sixty-four were selected and only forty patients completed the follow-up. In vivo sensitivity assay was used accompanied with standard regimen of Chloroquine phosphate. DNA was extracted from blood on filter paper (day 0) and was used to amplify two genes P. Falciparum transporters gene Pfcrt and multi-drug resistant gene-1 Pfmdr-1. Results: Among forty patients, 54% responded to Chloroquine regimen with adequate clinical response (ACR), however, 46% showed treatment failure. All treatment failures were treated with Artemether or Quinine. The amplification of Pfcrt gene (n, 18) and Pfmdr 1 gene (n, 29), had shown that 72% of Pfcrt T76 were mutant allele, 22% were K76 wild-type, however, only 5% were mixed alleles T/K. while Pfmdr 1 gene (n, 29) revealed that 55% were wild genotype N 86, 38% were mutant Y 86, and 7% were mixed alleles Y/ N 86. Conclusion: The high frequency of the mutant Pfcrt 76T gene among P. Falciparum isolates was consistent with in vivo study supports the hypothesis that Pfcrt 76T gene could be used as predictive marker for Chloroquine susceptibility in epidemiological surveys

APPLICATION OF PCR TECHNIQUES FOR TB DIAGNOSIS AT THE INSTITUTE OF NUCLEAR MEDICINE, MOLECULAR BIOLOGY & ONCOLOGY (INMO) - UNIVERSITY OF GEZIRA, SUDAN

Traditional methods for laboratory diagnosis of tuberculosis (TB) may require weeks, and delays can impede treatment and control efforts. Nucleic acid amplification (NAA) tests, such as polymerase chain reaction (PCR) and other methods for amplifying DNA and RNA, may facilitate rapid detection of microorganisms. This study emphasized our three years experience in the diagnosis of TB on clinical samples using the PCR method. Among 531 patients with suspected TB, 112 (21.3%) were positive by PCR, while 419 (78.7 %) were negative. The specimens collected from TB suspected patients were sputum, blood, ascitic fluid, pleural fluid, and gastric wash. Blood samples showed high positive results 15/41 (34%) in comparison with sputum samples which is the most frequent sample 64/ 285 (22.3%). Gastric wash samples reported low rate of positive result 1/30 (3.3%). This rapid and sensitive test compared with the other cultural and microscopic tests have now been incorporated into our laboratory practice allowing the physicians to manage proper diagnosis and drug regimens

Management of undiagnosed pheochromocytoma with acute appendicitis

The authors reported and discussed management a case of undiagnosed pheochromocytoma suspected because the catastrophic hemodynamic changes in a patient with an acute appendicitis

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

Geological mapping of carbonatites and related ores from the Oulad Dlim massif (Dakhla Province, Morocco) using remote sensing, portable X-ray fluorescence, and mineralogical data

Abstract and Poste

Variants of CTGF are associated with hepatic fibrosis in Chinese, Sudanese, and Brazilians infected with Schistosomes

Abnormal fibrosis occurs during chronic hepatic inflammations and is the principal cause of death in hepatitis C virus and schistosome infections. Hepatic fibrosis (HF) may develop either slowly or rapidly in schistosome-infected subjects. This depends, in part, on a major genetic control exerted by genes of chromosome 6q23. A gene (connective tissue growth factor [CTGF]) is located in that region that encodes a strongly fibrogenic molecule. We show that the single nucleotide polymorphism (SNP) rs9402373 that lies close to CTGF is associated with severe HF (P = 2 × 10−6; odds ratio [OR] = 2.01; confidence interval of OR [CI] = 1.51–2.7) in two Chinese samples, in Sudanese, and in Brazilians infected with either Schistosoma japonicum or S. mansoni. Furthermore, SNP rs12526196, also located close to CTGF, is independently associated with severe fibrosis (P = 6 × 10−4; OR = 1.94; CI = 1.32–2.82) in the Chinese and Sudanese subjects. Both variants affect nuclear factor binding and may alter gene transcription or transcript stability. The identified variants may be valuable markers for the prediction of disease progression, and identify a critical step in the development of HF that could be a target for chemotherapy

Signatures of the Preagricultural Peopling Processes in Sub-Saharan Africa as Revealed by the Phylogeography of Early Y Chromosome Lineages

Abstract The study of Y chromosome variation has helped reconstruct demographic events associated with the spread of languages, agriculture, and pastoralism in sub-Saharan Africa, but little attention has been given to the early history of the continent. In order to overcome this lack of knowledge, we carried out a phylogeographic analysis of haplogroups A and B in a broad data set of sub-Saharan populations. These two lineages are particularly suitable for this objective because they are the two most deeply rooted branches of the Y chromosome genealogy. Their distribution is almost exclusively restricted to sub-Saharan Africa where their frequency peaks at 65% in groups of foragers. The combined high-resolution single nucleotide polymorphism analysis with short tandem repeats variation of their subclades reveals strong geographic and population structure for both haplogroups. This has allowed us to identify specific lineages related to regional preagricultural dynamics in different areas of sub-Saharan Africa. In addition, we observed signatures of relatively recent contact, both among Pygmies and between them and Khoisan speaker groups from southern Africa, thus contributing to the understanding of the complex evolutionary relationships among African hunter-gatherers. Finally, by revising the phylogeography of the very early human Y chromosome lineages, we have obtained support for the role of southern Africa as a sink, rather than a source, of the first migrations of modern humans from eastern and central parts of the continent. These results open new perspectives on the early history of Homo sapiens in Africa, with particular attention to areas of the continent where human fossil remains and archaeological data are scant