Malaria, Schistosomiasis, and Related Anemia

Parasitic infections (e.g., malaria and helminthiases) have a huge impact on public health in endemic areas. Moreover, parasitic infestations are prominent causes of anemia in the tropics and subtropics, further perpetuated by malnutrition, inflammatory, and genetic diseases. Anemia-associating parasitic infections vary depending on the requirements and pathophysiology of the parasites. There is an interplay between different factors that can be segregated as host and parasite factors, resulting in severe anemia accompanying these parasitic infestations. The pathophysiological mechanisms leading to anemia associated with the different parasites vary greatly, including hemolysis, anemia of inflammation, bone marrow suppression, and micronutrients deficiency. The major means to deal with this anemia include prevention and treatment of such infestations

Accuracy of tympanic temperature measurement using an infrared tympanic membrane thermometer

BACKGROUND: During investigation and diagnosis of patients, accurate temperature measurement is of great importance. The advantages of tympanic membrane thermometry are speed (temperature reading available within seconds), safety, and ease of use. The aim of this study was to compare the accuracy of infrared tympanic thermometers in comparison to mercury thermometers in measurement of body temperature. METHODS: Axillary and tympanic temperature was measured simultaneously in consecutive patients using mercury glass and infrared tympanic thermometers at Omdurman Hospital, Sudan during October 2012. RESULTS: In total, temperature was measured in 174 patients, 95 of whom (54.6%) were male. The mean (SD) patient age and weight was 33.18 (25.07) years and 52.13 (69.85) kg. There was no significant difference in mean (SD) temperature measurement between mercury and infrared tympanic membrane thermometers, 37.29°C (0.91) versus 37.38°C (0.95), P = 0.373, respectively. There was a significant positive correlation between axillary and tympanic body temperature measurements (r = 0.697, P < 0.001). The mean difference between the two readings (with limits of agreements) was - 0.093 (−0.20; 0.02) °C. CONCLUSION: In this study, tympanic membrane thermometry is as reliable and accurate as axillary mercury glass thermometry. Thus, tympanic thermometry can be used in clinical practice, especially in the emergency setting, where ease of use and speed of obtaining the temperature reading are important

Hepatitis B Virus, Hepatitis C Virus and Human Immunodeficiency Virus Infections among Pregnant Women in Central Sudan

Background: The epidemiology of viral hepatitis and Human immunodeficiency virus (HIV) during pregnancy is of great importance for health planners and program managers. However, few published data on viral hepatitis and HIV are available in Sudan especially during pregnancy.Objectives: The current study was conducted to investigate seropositivity of hepatitis B, hepatitis C, and HIV among pregnant women in central Sudan.Materials and methods: A cross sectional study was conducted where 396 pregnant women were investigated for the presence of hepatitis B, C and HIV. Enzyme linked immunosorbent assay (ELISA) was used to detect HBsAg and anti-HCV. Antibodies to HIV were detected by three different methods as per Strategy III of the National AIDS Control Organization by utilizing different systems of testing to make a diagnosis of HIV.Results: Twenty (5.1%), five (1.3%), and six (1.5%) women were seropositive for HBsAg anti- HCV antibodies and HIV, respectively. One (0.003 %) woman was seropositive for both HBsAg and anti-HCV antibodies. While age, parity, were not associated with seropostivtiy of HBsAg, home delivery was the only significant risk factor for seropostivtiy of HBsAg (OR=4.5 (95% CI=1.2-16.7)Conclusion: Prevalence of HBV and HCV among pregnant women in this setting is in the intermediate zone of endemicity. This is alarming and should draw medical authorities’ attention if vertical transmission is to be reduced.Key words: Sudan, hepatitis B, hepatitis C, HIV, seropositivity, Pregnancy

Ultrasound- guided fine needle aspiration cytology and cell block in the diagnosis of focal liver lesions at Khartoum Hospital, Sudan

Background: The appropriate clinical management of various hepatic lesions depends on accurate diagnosis. Fine needle aspiration and cell block have gained popularity because they are convenient, minimally invasive, quick and have good performance profiles.Objective: To investigate the cytomorphological features of distinctive non-neoplastic and neoplastic lesions of the liver and to evaluate the sensitivity, specificity and diagnostic accuracy of ultrasound- guided (USG) fine needle aspiration cytology (FNAC) and cell block in the diagnosis ofliver diseases at Khartoum Teaching Hospital.Method: A cross-sectional study was conducted at Khartoum Teaching Hospital, Sudan during the period of November 2008 to October 2011. One hundred and five cytological materials were collected from patients with focal liver lesions who referred after initial clinical and radiologicalassessment for ultrasound–guided fine needle aspiration cytology (USG -FNAC).Results: The age of the patients ranged from 5- 60 years and 64 (61%) of these patients were males. Out of 105 investigated samples 76 (72.4%) and 41(39.0%) were malignant by cytology and cell block respectively. Out of these 105 samples, 71 were investigated by both cytology and cell blocks and were included in the final analyses of the FNAC in comparison to cell block. The sensitivity, specificity, positive predictive value and negative predictive value of the cytology were 100% (93.0 – 100%), 63.3% (45.2 – 79.0%), 78.8% (66.2 – 88.3%) and 0 (0 – 14.6%), respectively.Conclusion: Thus, USG -FNAC is a sensitive but not specific method in differentiating the benign and malignant focal liver lesions. Differentiation between primary liver malignant lesions and metastatic lesion needs adjunct techniqueKey words: neoplastic lesion, non-neoplastic lesio

Drugs use during pregnancy at Medani Maternity Hospital, Sudan

Background: There is a limited knowledge on use of drugs during pregnancy including beneficial and possible adverse effects of drugs on both the mother and the fetus.Objective: To investigate epidemiology of use of drugs during pregnancy.Methods: A cross sectional hospital based study at Medani Hospital during the period December 2011. After signing an informed consent, a pre-tested questionnaire was used to gather data from each parturient mother on her age, parity, level of education, antenatal care visits and use of drug during the index pregnancy.Results: The vast majority (334; 98.2%) of the interviewed women used drugs during the index pregnancy. Around ten percent (35; 10.5%) of these women used the drugs in the first trimester of pregnancy. The majority (266; 78.2%) used the drugs in third trimester and the rest used it in the second trimester. The most common drugs used were antibiotics, tonics, antimalarials and antiemetic.Conclusion: There is a very high rate of drug use in this setting. Antibiotics and antimalarials drugs were the most used drugs.Keywords: drugs, pregnancy, antibiotics, antimalarials, Sudan

Hepatitis C infection at a tertiary hospital in South Africa: Clinical presentation, non-invasive assessment of liver fibrosis, and response to therapy

Background. Hepatitis C is a viral infection that leads to chronic liver disease, resulting in significant morbidity and mortality.Objectives. To describe the demographic characteristics and clinical presentation of patients with chronic hepatitis C infection. The aspartate aminotransferase-to-platelet ratio index (APRI) and the fibrosis index based on 4 factors (FIB-4) were assessed for prediction of liver fibrosis.Methods. We retrospectively reviewed 87 records of patients who presented to the liver clinic at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, from January 2007 to December 2016. Patients’ records were reviewed and analysed using SPSS statistical software version 24. Convenience sampling was used.Results. The patients’ mean (standard deviation (SD)) age was 52.6 (12.3) years. Fifty-four percent were female. Hepatitis C virus genotype 5 was exclusively found in blacks (p&lt;0.001), constituting 60.3% of infections in this ethnic group and 48.7% in the cohort, followed by genotype 1 (21.8%), genotype 3 (15.4%), genotype 4 (10.3%) and mixed-genotype infections (3.8%). Genotype 5 patients were older (mean (SD) age 56.7 (9.8) years) than genotype 1 (46.3 (11.4) years) and genotype 3 (42 (9.8) years) (p=0.002 and p&lt;0.001, respectively). The receiver operating characteristic curve for METAVIR F0 v. APRI (cut-off &lt;0.7) showed a moderate correlation, with an area under the curve (AUC) of 0.349 (p=0.002), sensitivity of 78.8%, specificity of 70.6% and a negative predictive value (NPV) of 63.2%. METAVIR F4 v. APRI (cut-off ≥1.5) showed an AUC of 0.881 (p=0.001) with sensitivity of 85.7%, specificity of 93% and a positive predictive value (PPV) of 67%. METAVIR F0 v. FIB-4 (cut-off &lt;1.45) showed a moderate correlation, with an AUC of 0.332 (p=0.021), sensitivity of 78.3%, specificity of 53.8% and an NPV of 73.7%. METAVIR F4 v. FIB-4 (cut-off &gt;3.25) had a strong correlation, with an AUC of 0.952 (p&lt;0.001), sensitivity of 63.6%, specificity of 100% and a PPV of 100%. Early virological response (EVR) was found to predict sustained virological response (SVR) to therapy (odds ratio 27.8; 95% confidence interval 2.8 - 274.3; p=0.004).Conclusions. Compared with other genotypes, genotype 5 was predominant in our cohort, particularly in older age groups. Moreover, APRI and FIB-4 scores correlated significantly with advanced fibrosis in HCV patients. Finally, EVR during therapy was found to determine SVR

The Prevalence and Risk Factors of Osteoporosis among a Saudi Female Diabetic Population

 AIM: This study aimed to assess the prevalence and determinants of osteoporosis [lumbar spine (LS) and femoral neck (FN)] among patients with type 2 diabetes at King Salman Hospital.MATERIALS AND METHODS: One hundred seventy patients with type 2 diabetes were enrolled in this cross-sectional study in the period from the 1st of January until the 1st of July 2015. Patient selection was based on self-report of the previous diagnosis by a physician, being on an antidiabetic agent, or a fasting glucose of 126 mg/dl as per the American Diabetes Association criteria. A dual energy X-ray absorptiometry scan with the bone mineral density (BMD) categorization based on the WHO cut of levels of T-scores and determination of vitamin D levels were performed. A detailed questionnaire was used to collect demographic data.RESULTS: Out of 170 participants, 50 (29.4%) were diagnosed as having osteoporosis, while 68 (40%) were diagnosed with osteopenia. Age was determined as a risk factor for a decreased BMD in patients with osteopenia (odds ratio (OR) = 1.1, 95% confidence interval (CI) = (1.0-1.1), p = 0.039) and osteoporosis (OR = 1.1, CI = 1.0-1.2, p &lt; 0.001). Similarly, oral hypoglycemic agents (OHA) increased the risk of decreased BMD in osteopenia (OR = 2.6; CI = 1.0-6.7; p = 0.023) as well as osteoporosis, (OR = 3.8; CI = 1.3-10.9; p = 0.013), while vitamin D deficiency increased the risk of osteopenia OR = 3.0; CI = 1.2-7.2; p = 0.012). Increased BMI decreased the risk of both osteopenia and osteoporosis (OR = 0.9; CI = 0.9-0.99; p = 0.031 vs. OR = 0.9; CI = 0.80-0.95; p = 0.003).CONCLUSION: Advanced age, OHA and vitamin D deficiency are determinants of decreased BMD in Saudi women with type 2 diabetes, while an increased BMI protects against low BMD

No Association between 25 (OH) Vitamin D Level And Hypothyroidism among Females

AIM: The aim was to investigate serum vitamin D (25-OH) level among females with hypothyroidism.MATERIALS AND METHODS: A case-control study (58 in each arm) was conducted in Arar Central Hospital, Kingdom Saudi Arabia. The cases were females with hypothyroidism, and healthy females were controls. TSH, thyroid hormones: Free T3 (FT3) and Free T4 (FT4) and haemoglobin levels were measured in all participants. Serum vitamin D (25-OH) level was measured using the spectrophotometry.RESULTS: While there was no significant difference in the age and haemoglobin level, body mass index (BMI) was significantly higher in the cases. Compared with the controls, cases had significantly higher TSH, had significantly lower T4, and there was no significant difference in FT3 and 25 (OH) vitamin D, [16.1 (8.8-26.7) vs. 14.0 (9.5-20.3 ng/ml; P = 0.577]. Linear regression showed no association between, age, BMI, haemoglobin, TSH, FT3, FT4 and the log of 25 (OH) vitamin D levels.CONCLUSION: There was no significant difference in vitamin D level among females with hypothyroidism and healthy controls

Air quality modelling using chemometric techniques

The datasets of air quality parameters for three years (2012-2014) were applied. HACA gave the result of three different groups of similarity based on the characteristics of air quality parameters. DA shows all seven parameters (CO, O3, PM10, SO2, NOx, NO and NO2) gave the most significant variables after stepwise backward mode. PCA identifies the major source of air pollution is due to combustion of fossil fuels in motor vehicles and industrial activities. The ANN model shows a better prediction compared to the MLR model with R2 values equal to 0.819 and 0.773 respectively. This study presents that the chemometric techniques and modelling become an excellent tool in API assessment, air pollution source identification, apportionment and can be setbacks in designing an API monitoring network for effective air pollution resources management