Diabetic Foot Lesions on Rise, Investigating Predicting Factors in a Developing Country

Background: Diabetic foot lesions (DFL) are one of the devastating complications of diabetes mellitus (DM). Numerous factors interlinked to cause DFL which starts as ulcer & end up as amputation. Apart from the direct effect on individuals it has indirect impact on society in terms of decreased productivity. Large scale preventive programs targeting predicting factors of DFL are needed to minimize its burden. The aim of this study is to investigate multiple predicting factors of DFL on poor, limited resources community to aid in fighting this disease. Materials & Methods: This is an analytical case control study conducted in Jabir Abu Alaiz diabetic centre in Khartoum Sudan in june & july 2014. 88 adult DFL patients were enrolled as cases & 182 adult diabetic patients were enrolled as controls. Data were collected on DM duration, glycaemic control, neuropathy, vasculopathy, retinopathy, feet deformity, history of ulcers among demographic & other variables. Frequency matching was done on design stage. Bivariate & multivariate analysis were conducted for multiple possible predicting factors. Results: Recurrent ulcers (OR 3.525 95% CI (1.66-7.48) p-value (0.001)), & feet deformity (OR 3.186 95% CI (1.6-6.3) p-value (0.001)) proved to be statistically significant predicting variables. Suboptimal foot care clinics visits & diabetic foot wear was observed. Conclusion: Recurrent ulcers & feet deformity are predicting factors to DFL among others. Those diabetic patients should be aware about suitable preventive methods against DFL. Health education about foot care clinics role & enhancement of their utilization beside diabetic foot wear is mandatory

Seroprevalence and associated risk factors of Dengue fever in Kassala state, eastern Sudan

Dengue is a rapidly growing public health threat in Kassala state, eastern Sudan. The objective of this study was to determine the seroprevalence, entomological transmission indices, and socioeconomic risk factors associated with dengue in this region. A cross-sectional community-based study was conducted in four dengue-endemic sites; Khatmia, West Gash, Thoriba, and Shokriya between March 2016 to March 2017. Enzyme-linked immunosorbent assay (ELISA) of immunoglobulin G (IgG) was used to determine the prevalence of dengue virus among the study participants. An entomological survey was conducted using pyrethrum spray catch and dipping for the collection of adults and aquatic stages of Aedes aegypti, respectively. Ribonucleic acid was extracted from the buffy coat of participants as well as from adult female Ae. aegypti to assess the possible circulation of dengue virus using Reverse Transcription Polymerase Chain Reaction (RT-PCR). Multiple logistic regression model was used to estimate the association between potential risk factors and dengue seropositivity. A total of 409 persons were recruited to the study: 45.5% were in the 20-39 years' age category; 57.9% were living in houses with 6-10 persons; and 29.1% had at most secondary school education. In the majority (65.8%) of the households, the socioeconomic status was low (P 60 years) (OR 6.31, CI 1.09-36.36); type of bathroom (OR 3.52, CI 1.35-9.20); using water-based air conditioner (OR 6.90, CI 1.78-26.85) and previous infection of any household member with dengue (OR 28.73, CI 3.31-249.63). Our findings suggest that Kassala state is facing an increasing occurrence of dengue and emphasizes the need for developing appropriate interventions to address the identified risk factors, and place control programs into actions. Establishment of routine dengue epidemiological and entomological surveillance, and climate warning systems will contribute to early warning and timely detection and response to emerging outbreaks

The Family Streptomycetaceae

The family Streptomycetaceae comprises the genera Streptomyces, Kitasatospora, and Streptacidiphilus that are very difficult to differentiate both with genotypic and phenotypic characteristics. A separate generic status for Kitasatospora and Streptacidiphilus is questionable. Members of the family can be characterized as non-acid-alcohol-fast actinomycetes that generate most often an extensively branched substrate mycelium that rarely fragments. At maturity, the aerial mycelium forms chains of few to many spores. A large variety of pigments is produced, responsible for the color of the substrate and aerial mycelium. The organisms are chemoorganotrophic with an oxidative type of metabolism and grow within different pH ranges. Streptomyces are notable for their complex developmental cycle and production of bioactive secondary metabolites, producing more than a third of commercially available antibiotics. Antibacterial, antifungal, antiparasitic, and immunosuppressant compounds have been identified as products of Streptomyces secondary metabolism. Streptomyces can be distinguished from other filamentous actinomycetes on the basis of morphological characteristics, in particular by vegetative mycelium, aerial mycelium, and arthrospores. The genus comprises at the time of writing more than 600 species with validated names. 16S rRNA gene sequence-based analysis for species delineation within the Streptomycetaceae is of limited value. The variations within the 16S rRNA genes—even in the variable regions—are too small to resolve problems of species differentiation and to establish a taxonomic structure within the genus. Comprehensive comparative studies including protein-coding gene sequences with higher phylogenetic resolution and genome-based studies are needed to clarify the species delineation within the Streptomycetaceae