The association of polypharmacy to diabetes distress among patients with type 2 diabetes mellitus attending an outpatient clinic in Omdurman-Sudan

Introduction: Diabetes distress and polypharmacy are causes of concern among diabetic patients. The present study assessed the association of polypharmacy to diabetes distress among patients with type 2 diabetes mellitus. Methods: A cross-sectional descriptive study conducted among 103 consecutive patients with type 2 diabetes at an outpatient clinic in Omdurman, Sudan during the period from June 2016 to September 2016. Participants signed a written informed consent, then interviewed to collect demographic data, number and type of drugs taken to assess the polypharmacy and the duration of diabetes mellitus. A blood sample was taken for fasting plasma sugar and the HbA1c. The 17-items diabetes distress scale was used to assess diabetes distress. The ethical committee of Omdurman Teaching Hospital approved the research and the Statistical Package for Social Sciences was used for data analysis. Results: They were 103 patients with type 2 diabetes, their age mean± SD (59.64 ± 9.6), the mean HbA1c was 9.91 ± 2.65, the majority (70.9%) had poor glycemic control (HbA1c > 7) and the fasting plasma sugar was above the goal recommended by the American Diabetes Association in 82.4% of the participants. Polypharmacy was observed in 31.1% of patients. No differences were found between patients on polypharmacy and those without regarding age, diabetes duration, the glycated hemoglobin and diabetes distress. Conclusion: No significant statistical difference was found between polypharmacy patients and their counterparts regarding diabetes distress score

Concepts and models for the characterization of the West Gedaref hydrogeologic system, Sudan

thesi

The Best Time for Completion Thyroidectomy on Differentiated Thyroid Carcinoma: A Literature Review

Background: Completion thyroidectomy is performed for high-risk differentiated thyroid carcinoma; however, the timing of the completion  thyroidectomy is a matter of controversy. The current review aimed to assess the best time for completion thyroidectomy in patients with differentiated thyroid carcinoma.Methods: An electronic search was conducted in various databases, such as Pub Med, Google Scholar, Scopus, and Medline, for relevant articles assessing the timing of completion thyroidectomy from the first published article to October 2019. Keywords, “completion thyroidectomy” and “timing” were used. The search was limited to articles published in the English language. Among the 190 articles retrieved, only 11 fulfilled the inclusion criteria.Results: Of the 11 articles included, two were from Europe, one from Africa, one from Australia, and seven from Asia, and all were retrospective studies with the mean duration of studies being 12.71 ± 12.31 years. Five studies (45.5%) showed no effect of timing on the outcomes, two (18.2%) recommended both early and late operation, another two (18.2%) concluded that late operation is better, one (9.1%) found that early surgery is better, while one study (9.1%) stated that the timing of operation should be based on the category of the patient.Conclusions: The results were mixed with some studies recommending late completion thyroidectomy, some observing that both early and late  thyroidectomy are safe, while some finding no effect of time on the completion thyroidectomy. Welldesigned controlled trials will resolve the issue. Keywords: early completion thyroidectomy, late thyroidectomy, timing&nbsp

Phytosociology and Biodiversity Indices of the Woody plants of Alfula Area, West Kordofan, Sudan

This study was conducted in Alfula area, west Kordofan state.  This study aimed at determining the floristic composition, phytosociology, and species diversity of woody species and to produce a checklist of the encountered woody flora. Qualitative and quantitative data collected from fourty circular sample plots of 0.1ha (17.84m radius), The Shannon-Wiever and Pielous indices were used to assess species diversity, also similarity between sampled sites and distribution pattern of species  was assessed. Fifty-eight species belongs to16 families were recorded. The diversity indices values varying along studied sites. The total highest density of all trees and shrubs was 866 stem/ha. most dominant species is Geuara senegalensis. Most species were aggregately distributed.Keywords: Species diversity, distribution, similarity, vegetation

Fatigue, Nonrestorative Sleep and Associated Factors Among Sudanese Patients with Type 2 Diabetes: A Case-Control Study

Background: Fatigue, nonrestorative sleep, and other sleep disorders could be pointers to serious medical problems like obstructive sleep apnea; when present in patients with diabetes, they exacerbate each other deleterious consequences. The present study aimed to assess fatigue, nonrestorative sleep, sleep duration, and daytime sleepiness among patients with type 2 diabetes. Methods: This cross-sectional descriptive study was conducted among 103 consecutive patients with type 2 diabetes and 121 healthy controls attending an outpatient clinic in Omdurman, Sudan during the period from December 2015 to June 2016. All participants signed a written informed consent and were interviewed using a questionnaire based on Epworth Sleepiness Scale to assess subjective nonrestorative sleep, sleep duration, and snoring. A blood sample was taken for the HbA1c. The local ethical committee approved the research, and chi-square test and t-test were used for data analysis. Results: Highly significant statistical differences were observed between the diabetic patients and the control subjects regarding fatigue, nonrestorative sleep, sleep duration, snoring, and excessive daytime sleepiness (P-value < 0.001). Patients with fatigue had higher nonrestorative sleep than those without, no significant differences were found between patients with the symptoms of fatigue and those without regarding excessive daytime sleepiness, snoring, sleep duration, and the HbA1c (P-value > 0.05). Conclusions: Fatigue, nonrestorative sleep, sleep duration, excessive daytime sleepiness, and snoring were common among patients with type 2 diabetes than their healthy counterparts, diabetic patients with fatigue had more nonrestorative sleep than those without. The reliance on a self-administered questionnaire is a limitation of the study.  Keywords: fatigue, nonrestorative sleep, excessive daytime sleepiness, diabetes mellitus, Suda

Rapid Methods for Analysis of Edible Oils and Fats by Fourier Transform Infrared Spectroscopy

Analysis using Fourier transform infrared (FTIR) spectroscopy techniques on edible fats and oils extracted from palm fruit, groundnut, sesame seed, cottonseed and animal body fats rendered from cow, chicken, lamb and lard were investigated. The studies included development and applications of rapid FTIR techniques to determine some quality parameters such as moisture content in crude palm oil (CPO), soap and hexane residues in refined palm oil and groundnut oil, malondialdehyde (MDA) as a secondary oxidation product in refined palm oil, minor components such as sesamol and gossypol in sesame and cottonseed oils, and aflatoxins in groundnut and groundnut cake. The detection of lard in different mixtures with other animals' body fats such as cow, chicken and lamb was also investigated. Different sample handling techniques were used such as transmission cells of NaCl, BF2, KBr and attenuated total reflectance (ATR) using internal reflectance element (IRE) of ZnSe. Partial Least Square (PLS) and Principle Component Analysis (PCA) statistical methods were used to drive calibrations from FTIR versus actual or chemical values. In this study the frequency of 3700-3072 cm⁻¹ was used to determine moisture content in CPO as it indicates the absorption of compounds containing hydroxyl groups (OH). The frequency at 1675- 1500 cm⁻¹ was used to determine soap residues in refined edible oils. For the determination of hexane residue in oils, the frequency used included all the data from 2935-2817 cm⁻¹, 1 490-1333 cm⁻¹ and 1200-1000 cm⁻¹ for -CH₃ and -CH₂, and in-plane -CH bending. In the determination of MDA as a secondary oxidation product, the correlation and variance spectra were used to select the best regions (2900-2800 and 1800-1600 cm⁻¹) to derive calibration from FTIR versus values obtained by chemical methods with SEC of 1.49. The spectral regions included the data from 3650-3000, 1600- 1450 and 1200-900 cm⁻¹ that were used to determine sesamol in sesame seed oil. The study also included a qualitative and semi quantitative determination of palm and groundnut oils as adulterants in sesame seed oil using the spectral regions from 1504- 1503, 1400- 1397 and 917-914 cm⁻¹. The gossypol was also determined as an important quality factor in cottonseed oil and cakes using the spectral regions from 3600-2520 and 1900-800 cm⁻¹. The study also covered the detection of lard in mixture of body fats of chicken, lamb and cow by using changes in frequency and absorbance of spectral regions 3009-3000, 1418-1417, 1385-1370, 1126- 1085 and 966-967 cm⁻¹. The simple Beer-Lambert law was used to develop equations for the determination of mixtures. Aflatoxins exhibit characteristic absorption bands at wavelengths of 3004-2969 cm⁻¹ for CH₂, aromatic =CH, -C-H, C=C and phenyls, 1744-1720 cm⁻¹ for C=O, 1364-369 cm⁻¹ for methyl adjacent to epoxy ring, 1217-1220 cm⁻¹ for in plane -CH bending of phenyl, 1035-1037 cm⁻¹ for symmetric stretching of =C-O-C or symmetric bending of phenyl, and 900-902 cm⁻¹ which may be for isolated H. In this calibration set the spectral regions that showed the highest correlation between concentration information and spectral response were set to include the data from 3000-2932, 1832-1693, 1400-1329 and 1250-1187 cm⁻¹ for aflatoxins B₁, with standard errors of calibration (SEC) of 1.80 parts per million (ppm). All of the results were in good correlation and of comparable accuracy to the classical wet chemical methods such as the American Oil Chemists Society (AOCS), Association of Official Analytical Chemists (AOAC) and International Union of Pure and Applied Chemistry (IUPAC) methods. This study represents the use of FTIR spectroscopy as a new rapid analytical technique developed for determination of some quality parameters of fats and oils, together with the detection of adulterants and contaminants. The FTIR spectroscopic technique has the potential to replace the timeand effort-consuming chemical methods for fast analysis of fats and oils. This can also eliminate the use of toxic chemicals that are hazardous to the analysts as well as to the environment in the analysis

Rapid methods for analysis of edible oils and fats by fourier transform infrared spectroscopy

The objectives of this study were to develop fast, accurate, low cost, sensitive and environmentally friendly analytical methods for selected quality factors and minor components in edible oils and fats and their associated products using Fourier Transform Infrared (FTIR) spectroscopy. These analyses include soap residues in the chemically refined vegetable oils, quantifying hexane residues in the solvent extracted vegetable oils, detection of aflatoxins in groundnut and groundnut cake, the determination of malondialdehyde (MDA) as one of the thiobarbituric acid reactive substances (TBARS) in edible oils, the determination of minor components in edible oils such as sesamol and gossypol in sesame seed and cottonseed oils, respectively. In addition, the FTIR techniques were also be used to determine the adulteration of sesame seed oil with other vegetable oils and lard in body fats of chicken, lamb and cow

Thyroid Dysfunctions in Sudanese Patients with Vitiligo

Introduction: Vitiligo is a chronic acquired skin condition that causes loss of pigment, resulting in irregular pale patches of skin. The precise cause of vitiligo is not fully understood. The autoimmune base of the disease is supported by the frequent observation that several autoimmune disorders,particularly thyroid diseases, are associated with vitiligo.Objective: To determine the frequency of thyroid dysfunctions in Sudanese patients with vitiligo. Methods: Two groups, i.e. vitiligo patients and control, were collected with simple random collection. The control group included individuals free of vitiligo. 5 ml of venous blood was takenfrom every individual in both groups and the ELISA test was done for thyroid hormones, i.e. T3, T4 and TSH, using the DRG-USA kits.Results: The number of patients with vitiligo in the study was 46, while the control group was 45. Nine (19.56%) patients were found to have abnormal levels of thyroid hormones. No abnormal levels in the control group. Mean T3 level in patients was 1.463ng/l, while in control group it was 1.467ng/l. Mean T4 level in patients was 102.761 nmol/l, while in control group it was 90.844 nmol/l. Mean TSH level in patients was 0.841 μIU/l, while in control group it was 1.50 μIU/l. The t-test was done to determine the significance of difference between means of T3, T4, and TSH between the patients and control groups. The P-values were found to be significant.Conclusion: There is a strong pathogenetic relationship between vitiligo in Sudanese patients and thyroid dysfunctions.Keywords: T3 Triiodothyronin, T4 Tetraiodothyronin, TSH Thyroid stimulating hormon