Endocrine Hypertension

Arterial hypertension a prominent component of a number of endocrine disorders, most prominently those involving the adrenal glands (pheochromocytoma, primary aldosteronism and Cushing syndrome) and the pituitary (ACTH-producing tumors). Hypertension may also be a prominent feature of other endocrine disorders such as acromegaly, thyrotoxicosis, hypothyroidism, and hyperparathyroidism. Endocrine hypertension is noted in both adults and children but it is more relevant for children where it comes second to renal hypertension, the common cause of hypertension in that age group. Sudan Journal of Medical Sciences Vol. 3 (3) 2008: pp. 239-25

Essentials of Total Parenteral Nutrition: A review

The advent of total parenteral nutrition (TPN) in the late 1960s meant that no situation remained in which a patient could not be fed. Unfortunately, total parenteral nutrition was complicated in its early days by serious infective and metabolic side effects that undermined the beneficial effects of nutrient repletion. However, these TPN associated problems were minimized over time with the advancement of science, improvement of infection control measures, invention of suitable equipments, and experience. Now benefits are much greater than drawbacks. In this report we reviewed the literature and documented the indications, composition and preparation, as well as, procedure, and administration of TPN both in children and adults. We also discussed the possible complications of therapy and how to prevent it and manage it when present. We conclude by noting the progress of TPN service in Sudan.Keywords: artificial feeding, enteral feeding, trace elements, aminoacid

Bone-specific median age of hand-wrist maturation from Sudan

Background Maturation of bones in the hand–wrist region varies among individuals of the same age and among world groups. Although some studies from Africa report differences to other ethnic groups, the lack of detailed bone-specific maturity data prevents meaningful comparisons. Aim The aim of this study was to describe bone-specific maturity for developing hand–wrist bones in individuals in Khartoum, Sudan. Subjects and methods The sample was selected from healthy patients attending a dental hospital in Khartoum with known age and ancestry (males = 280, females = 330; aged between 3 and 25 years). Bones were assessed from radiographs of the left hand and wrist after the Greulich and Pyle Atlas (1959). Median ages of attainment for bone stages were calculated using probit analysis for each stage in males and females separately. Results Maturity data for stages of the phalanges, metacarpals, carpals and radius and ulna in males and females are presented. Median ages in females were earlier compared to males for all stages. These results are largely earlier than previously published findings or where these could be calculated. Conclusion These results of individual maturity stages of phalanges, metacarpals, carpals and the distal epiphyses of the radius and ulna are useful to assess maturity in growing individuals from Sudan

Post Transplant Diabetes Mellitus in Ahmed Gasim Kidney Transplant Center, Sudan

Introduction: New onset post transplant diabetes mellitus (PTDM) is a common complication of kidney transplantation with a negative impact on patient and graft survival. Non-white ethnicity is a well known risk factor for PTDM. Methods: This is a retrospective study of 221 Sudanese patients who received live donor kidney transplantation in Ahmed Gasim kidney transplant center between December 2001 and December 2007, focusing on the incidence, clinical course and prognosis of PTDM during the first post transplant year, and relating this to calcineurin inhibitor use. Results: The 12 months cumulative incidence of PTDM in our transplant population was 17.6% and all cases required treatment with insulin. 53.8% of PTDM cases were transient with a median duration of 76 days; by 12 months post transplant only 6.2% of patients were receiving insulin. The 12 months cumulative incidence of PTDM was higher in the tacrolimus compared to cyclosporine groups (25.4% versus 6.6%; OR 4.8, 95% CI: 1.9-12.1; P=0.00). During the follow up period 57.6% of PTDM patients in the tacrolimus group were able to discontinue insulin compared to 33.3% of PTDM patients in the cyclosporine groups (OR 2.7, 95% CI: 0.4-17; P=0.3). By 12 months post transplant, the proportion of patients receiving insulin was not significantly different between the two groups (8.0% versus 4.0%; OR 2.1, 95% CI 0.5-8.4; P = 0.2). Conclusion: The incidence of PTDM in our transplant population is not different from that reported in published randomized controlled trials and similarly, in the majority of cases PTDM was transient. Key words: Post transplant diabetes mellitus, kidney transplantation, tacrolimus, cyclosporine, calcineurin inhibito

Restoration of Kidney Function after Prolonged (Four Months)Anuria Due to Bilateral Renal Artery Occlusion

Introduction: Atherosclerotic renal artery stenosis (RAS) is usually one manifestation of wide spread atherosclerotic disease and its presence has a grave impact on prognosis. RAS is a progressive condition that can remain asymptomatic for a long time, only to present later with accelerated hypertension or renal insufficiency. The first approach to the management of atherosclerotic RAS consists of medical therapy to control blood pressure and other atherosclerotic risk factors. However, surgical or percutaneous revascularization can be of substantial benefit in selected patient groups. Case Report: A 37 year old man who was a heavy smoker and known to have hypertension for the previous five years presented with acute anterior myocardial infarction (MI). His serum creatinine was 8.5 mg/dl and he needed a session of acute peritoneal dialysis to relieve severe pulmonary edema. Subsequent investigations revealed the presence of bilateral total occlusion of the renal arteries resulting in severe renal impairment and dialysis dependency. He underwent two unsuccessful attempts at angioplasty. Surgical revascularization of both renal arteries was eventually carried out after four months of anuria, and was immediately followed by dramatic improvement of his kidney function. The patient, however, continued to receive antihypertensive medication for adequate blood pressure control. Conclusion: This case reflects the ability of the kidney to adapt to chronic ischemia, and underscores the importance of considering renal revascularization in all patients with renal artery occlusion, even after long periods of kidney non-functioning. Key words: renal artery occlusion, renaovascular disease, renal revascularization, ischemic nephropath

A Dynamic CGE Model: An Application of R&D- Based Endogenous Growth Model Theory

An R&D based endogenous growth - applied general equilibrium model is developed from an underlying analytical model which combines Romer's capital variety with Grossman and Helpman's multi-sector open economy model. The transitional dynamics of the analytical model are derived. For numerical implementation, a time discrete empirical model, with an Armington structure, is fit to East Asian data of the social accounting matrix variety. Simulations of trade reform are performed and their static and dynamic effects compared. The transition paths of the state variables are found to have a half-life of five to six periods. A solution of the Social Planner's problem, and interventions which seek to obtain this outcome from the decentralized model are also obtained'.Applied General Equilibrium, Trade, Growth, International Relations/Trade, F11, 031, 041,

RESPONSES OF CLASSIC SPAR PLATFORM SUBJECTED TO REGULAR WAVES

Increasing demand for Oil and Gas and decreasing onshore reserves has lead to Deep water exploration therefore it has accelerated the need to explore structures suitable for these depths, which operate more economically in deep water. A Spar platform is one such compliant offshore floating structure used for deep water applications for the drilling, production, processing, storage, and oftloading of ocean deposits. The Spar platform was modelled as a rigid body with six degrees-of freedom, connected to the sea floor by multi-component catenary mooring lines, which are attached to the Spar platform at the fairleads. The aim of this project was to conduct a simple dynamic rigid body analysis in time domain for a typical classic spar subjected to regular waves and then conduct a parametric analysis. The results obtained are within the permissible limits where the maximum Surge, Heave, & Pitch recorded were 1.2 m, 0.95 m, and -0.04 rad respectively for wave height of3.6 m and wave period of7 sec.

TRANSFORM DOMAIN SLICE BASED DISTRIBUTED VIDEO CODING

Distributed video coding depends heavily on the virtual channel model. Due to the limitations of the side information estimation one stationary model does not properly describe the virtual channel. In this work the correlation noise is modelled per slice to obtain location-specific correlation noise model. The resulting delay from the lengthy Slepian-Wolf (SW) codec input is also reduced by reducing the length of SW codec input. The proposed solution does not impose any extra complexity, it utilizes the existing resources. The results presented here support the proposed algorithm

Gower sign positive muscle weakness in a patient with short stature and hypophosphatemia

A 17-year-old Sudanese patient presented with short stature, generalized body aches, and proximal muscle weakness. He was seen by two orthopedic surgeons and an adult neurologist and misdiagnosed as having benign bone cysts, osteomalacia and Duchenne muscular dystrophy. Infact, he was suffering from severe hypophosphatemia, which manifest by unusual presentation. The diagnostic pitfalls are explained and the importance of urinalysis and measurement of bone minerals are emphasized.Keywords: Renal tubular acidosis, Fanconi syndrome, Rickets

Effect of some tillage methods and sowing dates on bulk density, soil moisture and sorghum yield in the rainfed areas of northern Gedarif , Gedarif State , Sudan

     The study was carried out during three consecutive seasons (2005/06, 2006/07 and 2007/08) under rain-fed conditions, to investigate the effect of some tillage methods and sowing dates  of  sorghum (Sorghum bicolor L.) on soil moisture  content, bulk density and sorghum grain  yield  in  northern Gedarif area, at the pilot farm of the Faculty of Agricultural  and Environmental Sciences, University of  Gedarif, Gedarif, Sudan. The experiment was laid out in a split plot design with three replicates. Main plots were assigned to three tillage methods; which were:  Zero tillage (ZT), offset disc as post harvest tillage(PHT) and farmers practice which was  wide level disc (WLD) as control, while sub-plots were assigned  to two sowing dates  which were early sowing date (S1) and late sowing date (S2). Post-harvest tillage treatment (PHT) resulted in significantly higher soil moisture content in the three growing seasons  compared to the other two treatments. Combined analysis indicated that ZT resulted in  significantly higher soil bulk density  in comparison with WLD and PHT treatments  for the three depths. The 3-years average grain yield for PHT, WLD and ZT were 1113 kg/ha, 976 kg/ha and 885 kg/ha, respectively.  The respective increase in yield was  26% and 14%.                                                                                                                                                                              The study was carried out during three consecutive seasons (2005/06, 2006/07 and 2007/08) under rain-fed conditions, to investigate the effect of some tillage methods and sowing dates  of  sorghum (Sorghum bicolor L.) on soil moisture  content, bulk density and sorghum grain  yield  in  northern Gedarif area, at the pilot farm of the Faculty of Agricultural  and Environmental Sciences, University of  Gedarif, Gedarif, Sudan. The experiment was laid out in a split plot design with three replicates. Main plots were assigned to three tillage methods; which were:  Zero tillage (ZT), offset disc as post harvest tillage(PHT) and farmers practice which was  wide level disc (WLD) as control, while sub-plots were assigned  to two sowing dates  which were early sowing date (S1) and late sowing date (S2). Post-harvest tillage treatment (PHT) resulted in significantly higher soil moisture content in the three growing seasons  compared to the other two treatments. Combined analysis indicated that ZT resulted in  significantly higher soil bulk density  in comparison with WLD and PHT treatments  for the three depths. The 3-years average grain yield for PHT, WLD and ZT were 1113 kg/ha, 976 kg/ha and 885 kg/ha, respectively.  The respective increase in yield was  26% and 14%.                                                                                                                                                                       &nbsp