Aerobic bacteria in safe type chronic suppurative otitis media in Gezira State, Sudan

Chronic suppurative otitis media (CSOM) is a challenging disease with a high burden on society in developing countries. Information regarding CSOM in Sudanese patients is scarce. This study aimed to identify aerobic bacteria involved in CSOM and to determine their sensitivity towards commonly prescribed antibiotics. A multi-center prospective cross sectional study was conducted between June 2012 and October 2013 in private and public ENT clinics in Gezira State, Sudan. The study included 217 CSOM patients most of whom were males or had unilateral disease. The most common isolates were Staphylococcus aureus (42.6%), Klebsiella pneumoniae (14.7%), Pseudomonas aeroginosa (12.5%) and Proteus mirabilis (10.2%). The sensitivity of all isolates was highest towards gentamicin and ciprofloxacin while multiple drug resistance was prominent towards amoxyclav, cotrimoxazole, cefuroxime, cefaclor and ceftriaxone. Ciprofloxacin and gentamicin appear to be the best choices for empiric therapy in patients with CSOM. In contrast, the use of amoxyclav, cotrimoxazole, cefuroxime, cefaclor and ceftriaxone should be discouraged.Keywords: Aerobic bacteria, Chronic suppurative otitis media, Gezira State, Sudan

Ectopic Thyroid Presenting as a Sublingual Mass in a Sudanese Girl

Although extremely rare, the presence of ectopic thyroid tissue in the sublingual region should be considered in the differential diagnosis of masses in the cervical region. Diagnosis is confirmed by Fine-needle Aspiration\Biopsy Cytology and exclusion of malignancy by histopathologic analysis of the lesion. In general, surgery should not be attemptrd before radioisotope scan is obtained as this might be the only functioning thyroid tissue.  This is a rare case of ectopic thyroid in the sublingual region reported in a Sudanese girl; it was diagnosed after radioisotope thyroid scan and proved to be the only functioning thyroid tissue. &nbsp

The Performance of Candidates in the Examinations of the Otorhinolaryngology Specialty, Sudanese National Board of Medical Specializations

Introduction: The Otorhinolaryngology, Head and Neck Surgery Council is one of the first established councils of the Sudanese National Board of Medical Specializations (SNBMS).This report covers the fourth rotation period from 2009-2013. It is meant to be in the form of an analytical study for more objectivity and transparency and to be a model for promotion of the general performance of other councils in administrative, examination and training issues. Objectives: The main objective of this study is to analyze the trainees’ results in part 1 and part 2 (final) examinations with regard to gender and pass rates and to draw relevant indices that help in planning for training and expansion of specialist services. Materials and Methods: This is an analytical retrospective study conducted at the (SNMSB) headquarters Khartoum, Sudan during the period from January 2009- December 2012 .This study covers the fourth rotation of the scientific council for the specialty. The study included all candidates sitting for both part 1 and part 2 examinations (265). Candidates were classified according to gender and pass rates. Candidates who withdrew form the program after passing the part 1 examination were excluded. Results:  The total number of doctors sitting for part 1 examinant was 207. Females were 118 and males were 89. Female to male ratio was 1.3:1.0. Sixty nine (69) doctors passed the examination with over all pass percentage of 33.3%. The percentage of passed candidates among females was 31% and among males was 36%. The total number for trainees sitting for the final examination was 58. Females were 23 and males were 35. Female to male ratio was 1.0: 1.5. Thirty three (33) trainees passed the examination with over all pass percentage of 56.9%. The percentage of passed trainees among females was 52.2% and among males was 60%. The annual number of doctors sitting for part 1 examination showed marked reduction from 69 in the first year to 48 in the fourth year although there was a steady increase in-between. The average annual pass rate for part 1 examination showed noticeable increase from 23% to 42% by the end of the fourth year. The annual number of trainees sitting for the final examination was fluctuating and the biggest number was in the first year. There was a minimal increase in the number of graduates.  Conclusions: Applicants for part one examination are mostly females. Applicants numbers are generally decreasing. The pass percentages are increasing in both parts of the examination. Males performance in both part one and part two examinations is better than females. The number of graduates does not satisfy the national needs for specialist services provision and expansion

Factors Affecting Activity of Cellulose Enzymes Produced By Three Fungi

Three fungi (Trichoderma viride, Asperigillus niger and Penicillium digitatum) were used in the present study for the production of the cellulase enzymes (carboxymethylcellulase and cellobiase). The effects of different metal ions on the activities of these enzymes were , caused a ++and Mn+ , K++, Ba++using the reducing group method. The addition of Ca investigatedsignificantly higher increase in the activity of the carboxymethylcellulase enzyme of the three . However, the addition ++and Zn++ e a less increase was found by the addition of Mgfungi, whilactivity. The activity of the is enzyme caused a decrease in th ++, and Fe++, Cu++, Cd+, Ag+of Naand +ence of Hg, but it was decreased in the pres+and K ++cellobiase was increased with Caat the was occurred A. nigerenzyme produced by cellobiasehe higher activity of the T.++Cd, however, ++Ca and ++900 ppm for Mn –500 , while it occurred at+900 ppm of K –200 of range P. and T. viride ase of bothobiFor the cell 900 ppm. –800 of at the range it occurred ,++Ba for . ++, no significant different was noticed with different concentrations of Cadigitatumfungi at all th ase enzyme of boobigave a lower activity for the cell ++On the other hand, Ba concentrations. The optimum temperature for the carboxymethylcellulase enzyme activity was at . P. digitatum and T. viride bothfor C 050 –C 0it was between 40 , whileA. niger50°C for C.0However, the optimum temperature for the cellobiase activity of the three fungi was at 40 The optimum activity of the carboxymethylcellulase enzyme produced by A. niger was at pH 4, and for that of T. viride was at pH 6. Two peaks were detected for the same enzyme produced by P. digitatum, at pH 6 and pH 7. However, the optimum pH value for the cellobiase enzymes produced by the three fungi was at pH 4.0only

Production and characterization of Pectic enzymes from three fungi

Pectins are compounds  that  are resistant   to  enzymatic  cleavage  in most  organisms  and  plants, Studies  were  therefore  made towards finding methods for hydrolyzing these compounds. One such approach  is enzymatic hydrolysis.  Three fungi   (Trichoderma   viride,    Asperigillus     niger   and penicillum   digitatum)  are   used   for  production   of   pectinase  enzymes, Two  methods (reducing  sugar and viscometary)  were  used  for  measuring enzymes activities. Pectin and sodium polypectate compounds were used  as substrates. The  production of  pectinases by the three fungi was investigated in culture media. T. viride and P. digitatum  gave  maximum   production  of pectinase  enzymes  after  two  week  and  A. niger  gave  it  after  one week. Purification   by   ammonium    sulphate   precipitation,     showed   that   the maximum  pectinase  activity  was  at   80%   concentration for both fungi A niger and P. digitatum. By using  gel  electrophoresis, five bands were found to   give   pectinase  enzymes   activities. The   present   study   showed    the importance   of   fungi   as   sources  of  enzymes and recommends that more studies  must   be   done   in   the  field of  biotechnology to produce glucose  from natural products by  using fungi. &nbsp

Correlation of CsK2Sb Photocathode Lifetime With Antimony Thickness

CsK2Sb photocathodes with quantum efficiency on the order of 10% at 532 nm, and lifetime greater than 90 days at low voltage, were successfully manufactured via co-deposition of alkali species emanating from an effusion source. Photocathodes were characterized as a function of antimony layer thickness and alkali consumption, inside a vacuum chamber that was initially baked, but frequently vented without re-baking. Photocathode lifetime measured at low voltage is correlated with the antimony layer thickness. Photocathodes manufactured with comparatively thick antimony layers exhibited the best lifetime. We speculate that the antimony layer serves as a reservoir, or sponge, for the alkali

Common Ear, Nose & Throat Problems in the Under- Five Sudanese Children

Introduction: The health problems of children and especially the under-5 years are of great concern and impact on both medical and surgical practice. No wonder they attract political and administrative concern Objective: This study aims to identify the common Ear, Nose & Throat (ENT) problems of under-5 Sudanese children and to study the frequency, admissions, available beds and operations and to compare this work load with the rest of the ENT wards. Furthermore, to outline what is needed to improve the services for this age group. Methodology: This is a retrospective hospital–based study including all patients (n=21384) who presented to the ENT department, Wad-Medani Hospital, Gezira, Sudan, during a period of two years from the first of January 2010 to the thirty first of December 2011. Results: The total number of the under-5 children was 2330; which contributed to 41.32% of total paediatric age group, up to 16 years, (n=5639) and 10.90% of the total number of ENT patients who presented to the ENT department at Wad-Medani Hospital. The total number of admissions of under-5 children accounted for 32.72% of all paediatric patients and 20.66% of all ENT patients. Their commonest problems found in this study were; adenoiditis & tonsillitis (37.68%), otitis media (27.25%), Upper respiratory tract infections (URTIs) & allergy (12.31%), foreign body related (12.23%), otitis externa (5.45%), others (3.43%), epistaxis (0.75%), hearing & speech disorders (0.90%). The total number of children under-5 requiring surgical operations constituted 55.46% of all paediatric patients and 33.98% of the total number of all ENT patients who were operated on. Of these operations 57.01% were elective and 42.99% were emergency operations. The main indications in 94.77% of the elective operations were adenoidectomy & tonsillectomy, while most of the surgical emergencies 91.32% were due to foreign body related problems. Conclusions: The ENT problems of the under-5 children in Wad-Medani General Hospital constitute an obvious high proportion of the work load. More attention is to be paid to this age group in terms of facilities, staff training and special requirements needed in settings and equipments. Thus, better handling and outcomes could be achieved for this important and delicate age group