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

Effects of different levels of sugar beet roots based concentrates on the performance of Tagger male kids

    High meat demand in the Sudan enhanced improvement of goat meat production. Tagger is a promising meat breed due to good conformation and high meat quality. Nutrition is a main constraint for goat meat production. Sugar beet is introduced into the Gezira State with no information on effects of dried sugar beet roots (DSBR) based concentrates level on Tagger kids performance, carcass characteristics and meat composition. Twelve Tagger males of 6 months old were housed in individual pens, divided into 3 groups, each with 4 animals and allocated at random to the experimental diets. They were weighed weekly for 8 weeks with a two weeks preliminary period. They were fed groundnut haulm (GNH) ad lib. in two equal meals at 8.0 am and 4.0 pm and refusals were collected and weighed daily. The animals were fed different levels of DSBR based concentrates: 0 (control), 150g and 300g, in two equal parts before GNH meals. The concentrates contained 68% DSBR,15% groundnut cakes, 15% sunflower cakes, 1% salt and 1% oyster shell. Samples of feeds and refusals were stored for laboratory analysis.  Resultd showed that groundnut haulm (30% CP, 8.8% CF, 4.8% ash and 48.2% NFE) had better proximate analysis than refusals which generally improved with concentrates levels. Dried sugar beet had 12.9% CP, 11.0% CF and 59.25% NFE and the concentrates had 42.25% CP, 2.0% CF and 49.5% NFE. Overall mean BW generally increased with concentrates level (10.78, 10.9 and 12.19kg at 0, 150 and 300g, respectively), but  not significantly different. Overall mean daily feed intakes varied with concentrates level and were 1550.89, 1187.46 and 1545.67g at 0, 150 and 300g concentrates, respectively, and were significantly least in animals fed 150g concentrates. Weekly weight gain generally increased with concentrates level in all weeks and was highest in animals fed 150g concentrates with no significant effects for concentrates level. It was 0.55, 0.68 and 0.60 kg at 0, 150 and 300g concentrates, respectively. It is recommended to use DSBR based concentrates in fattening Tagger kids.     حفز ارتفاع الطلب  على اللحوم وأسعارها في السودان تحسين لحوم الماعز. تعتبر التقر سلالة واعدة لإنتاج اللحوم لجودة القوام ونوعية اللحم.  إلا أن التغذية من المعوقات الرئيسة لإنتاج لحوم الماعز.  أدخل بنجر السكر لولاية الجزيرة ولا تتوفر معلومات عن أثر مستوى جذر البنجر الجاف) ج ب ج (على أداء جديان التقر وصفات الذبيحة  وتركيب اللحم.  وضعت 12 من ذكور جديان التقر بعمر 6 أشهر في حظائر فردية  وقسمت الى 3 مجموعات بكل منها 4 حيوانات  ووزعت عشوائيا على أعلاف الدراسة. وزنت الحيوانات أسبوعيا لمدة 8 أسابيع منها أسبوعين فترة إعدادية. أعلفت الحيوانات تبن الفول السوداني )ت ف س) حسب الرغبة في وجبتين متساويتين عند الثامنة صباحا والرابعة مساء وجمع ووزن العلف المتبقي.  كما أعلفت الحيوانات مستويات مختلفة من عليقة مركزة ترتكز على )ج ب ج  (عند صفر( الشاهد), 150 و300جم في جزئين متساويين  قبل وجبتي ت ف س. احتوت العليقة المركزة على 68% ج ب ج و15%  امباز فول سوداني و15%  تبن زهرة الشمس و1% ملح و 1% صدف  حفظت عينات من  الأعلاف والعلف المتبقي للتحليل المعملي.  حُللت المعلومات إحصائيا باستخدام تحليل التباين واستخدم اختبار دنكن لفصل اختلافات المتوسطات. كان  ت ف س (  30% بروتين خام ، 8.85 ألياف خام، 4.8% رماد و 48.2% جزء خالي من النتروجين) أحسن في التحليل التقريبي من المتبق.والذي تحسنت نوعيته بارتفاع مستوى العليقة المركزة. كان تركيب  ج ب ج 12.95 % بروتين خام ، 11% الياف خام و 59.25% جزء خالي من النتروجين .وتركيب العليقة المركزة  42.25 % بروتين خام ، 2% ألياف خام و 49.5% جزء خالي من النتروجين .  زاد متوسط الوزن الكلى مع زيادة العليقة المركزة (10.78 ،  10.9 و 12.19عند صفر و 150 و 300 جم عليقة مركزة على التوالي بدون فروقات معنوية . (P>.05)  تباين متوسط المتناول من العلف تبعاً لمستوي المركزات وكان 1550.89 و 1187.46 و 1545.67 جم عند صفر و 150 و300 جم عليقة مركزة ، علي التوالي وكان أقل معنوياً للحيوانات التي غُذيت علي  150عليقة مركزة.  تباينت زيادة الوزن الأسبوعي بزيادة مستوي العليقة المركزة في كل الأسابيع وكانت الأعلى للحيوانات عند 150 جم بدون زيادة معنوية. وكانت 0.55 و0.68 و 0.60 كجم عند صفر و 150 و300 جم عليقة مركزة، علي التوالي. يوصي باستخدام علائق جذور بنجر السكر المجففة لتسمين جديان التقر

Effects of Ethrel, packaging and waxing on degreening, quality and shelf life of sweet oranges

     Post harvest handling practices of sweet oranges are very poor in the Sudan and result in great losses. Oranges grown in central Sudan reach the ripe stage while they are still green in colour. The lack of orange colour development is due to the relatively high temperatures in this region. Therefore, the objective of this research was to find out the effects of Ethrel, packaging and waxing on sweet orange degreening, quality and shelf life. Experiments were conducted at the Faculty of Agricultural Sciences, University of Gezira, Wad Medani, Sudan, during the seasons of 2013-2014. Ripe, green oranges were treated with Ethrel at two concentrations: 1ml/l, 2ml/l or left untreated as a control. Packaging treatments consisted of wrapping oranges in intact or perforated polyethylene film, waxed or left unpackaged as control. Treatments were arranged in a completely randomized design with two replicates. Results showed that treatment of oranges with Ethrel at both concentrations significantly resulted in degreening of oranges and development of a uniform orange colour as compared to the control. Oranges packaged in intact polyethylene film or waxed recorded the minimum weight loss followed by those wrapped in perforated film, whereas the highest weight loss was recorded for the unpackaged and unwaxed oranges. Also, packaging in intact film or waxing of oranges resulted in the longest shelf life compared to the other treatments. Total soluble solids and vitamin C contents were highest in oranges packaged in intact film or waxed, whereas the least contents were recorded for the control. Ethrel treatment had no significant adverse effects on orange chemical composition. It is recommended to degreen oranges using Ethrel at 2ml/l and package them in intact polymeric film or coat them with wax.   معاملات ما بعد الحصاد للبرتقال في السودان غير متطورة وينتج عنها خسائر كبيرة. يصل البرتقال المنتج في أواسط السودان إلى طور النضج وهو أخضر اللون. يعزى عدم تلوين البرتقال إلى ارتفاع درجات الحرارة في هذه المنطقة.  الهدف من هذه الدراسة هو معرفة أثر مادة الأثرل على تلوين البرتقال وتأثير التغليف والتشميع على جودة وفترة صلاحية البرتقال. أجريت التجارب في كلية العلوم الزراعية، جامعة الجزيرة واد مدني السودان خلال موسمي 2013-2014م. تمت معاملة ثمار البرتقال الأخضر بمادة الأثرل 1 و 2 ملم/لتر أو ترك كشاهد. معاملات التغليف اشتملت على تغليف البرتقال في أكياس البولي إيثلين السليمة أو المخرمة أو التشميع أو بدون تغليف كشاهد. صممت التجارب نسق التصميم العشوائي الكامل بمكررين. أوضحت النتائج أن معاملة البرتقال بمادة الأثرل أدت إلى زوال اللون الأخضر وتلوين البرتقال بلون برتقالي جميل بالمقارنة مع الشاهد. تغليف البرتقال في أكياس البولي إثيلين السليمة أو تشميعه أدى إلى أدنى فقدان الوزن، يليه التغليف في أكياس مخرمة، بينما كان أعلى فقدان الوزن في الشاهد. محتوى المواد الصلبة الذائبة وفيتامين "ج" كان أعلى في البرتقال الذي تم تغليفه في أكياس البولي إيثلين السليمة أو التشميع، بينما كان أدنى محتوى في الشاهد. معاملة البرتقال بمادة الأثرل لم يكن لها أي تأثير ضار على التركيب الكيميائي للبرتقال. لذلك يوصي بمعاملة البرتقال الأخضر بمادة الأثرل لتلوينه وتغليف الثمار في أكياس البولي إيثلين السلمية أو التشميع للحفاظ على الجودة وزيادة فترة الصلاحية أو العمر التخزينية للبرتقال.   &nbsp

Effect of plant spacing on growth, yield and fruit quality of some introduced banana (Musa AAA) clones

    A field experiment was conducted at the Experimental Farm of the National Institute for the Promotion of Horticultural Exports, University of Gezira, Sudan, during 2009/10 and 2010/11. The objective of the study was to determine the effects of plant spacing on the vegetative growth, crop earliness, yield components, total yield and fruit quality of  five introduced banana clones under Gezira conditions, Sudan. Treatments consisted of three banana clones introduced from Austria, namely, Williams hybrid 172 (WH 172), Williams hybrid 1366 (WH 1366) and Grand Nain 1824 (GN 1824) and two clones introduced from South Africa, namely, Zelig and Bio. These five introduced clones were compared with the local clone Dwarf Cavendish (DC). Plant spacing was 2x2, 2x3 and 3x3 m. Treatments were arranged in a split plot design with three replicates. Plant spacing was assigned to the main plots and clones to the subplots. Results showed that vegetative growth parameters, yield and yield components were significantly affected by banana clones and plant spacing. Generally, the introduced banana clones had more vigorous vegetative growth than the local clone DC. The most vigorous vegetative growth was obtained by WH 172 followed by WH 1366 and GN 1824. Plant spacing of 2x3 m and 3x3 m resulted in significantly higher growth parameters values than 2x2 m. The earliest clone was GN 1824 and the latest were Bio and DC. Bio clone took the longest time from shooting to harvesting and both WH clones and Zelig  took the shortest. Plant spacing of 3x3 m resulted in significantly the shortest time from shooting to harvesting compared to the others. The highest yield and yield components were obtained by WH 172, WH 1366 and GN 1824 and the lowest were obtained by the local clone DC. Plant spacing of 3x3 m resulted in the highest yield components but the lowest total yield However, the close spacing of 2x2 m produced the lowest yield components but the highest total yield due to the large number of bunches per unit area. Total soluble solids were comparable in all clones, however, GN 1824 and WH 1366 had a better taste than the other clones. Plant spacing of 2x3 m and 3x3 m resulted in significantly higher TSS and taste values than 2x2 m. It is recommended to grow the banana introduced clones WH 172, WH 1366 and GN 1824 at a spacing of 2X3 m for the highest yield and best fruit quality.      أجريت التجارب بحقل بحوث المعهد القومي لتنمية الصادرات البستانية، جامعة الجزيرة، في الفترة من  2009 الي 2011. الهدف من الدراسة هو معرفة أثر مسافات الزراعة على النمو الخضري والتبكير ومكونات الإنتاج والإنتاجية ونوعية الثمار لخمسة أصناف من الموز مستجلبة من خارج السودان ، تحت ظروف الجزيرة بالسودان. اشتملت المعاملات على ثلاث سلالات من الموز مستوردة من النمسا وهي هجين الوليامز 172 (WH172) وهجين الوليامز 1366 (WH1366) وجراندنين 1824 (GN1824) وسلالتين استجلبتا من جنوب أفريقيا وهما زيلج وبايو. هذه السلالات الخمس المستجلبة من الخارج ثم تقويمها بالمقارنة مع السلالة المحلية الكافندش القزم (DC). مسافات الزراعة كانت 2 × 2م و 2 × 3م و 3×3م . نظمت المعاملات في تصميم القطع المنشقة بثلاث مكررات. اعتبرت مسافات الزراعة قطعاً رئيسية والسلالات قطعاً ثانوية. أظهرت النتائج أن تأثير السلالات ومسافات الزراعة كان معنوياً على النمو الخضري ومكونات الإنتاج والإنتاجية ونوعية الثمار. عموماً السلالات المستجلبة من الخارج أظهرت نمواً خضرياً أفضل من السلالة المحلية DC. أعطت السلالات WH172, و WH1366 وGN1824 نمواً خضرياً افضل من غيرها. مسافات الزراعة 2×3م و 3×3م أعطت نمواً خضرياً أفضل من 2×2م. أكثر السلالات تبكيراً هي  GN1824 وأكثرها تأخراً هي بايو وDC. استغرقت السلالة بايو زمناً أطول من الإزهار وحتى الحصاد أما السلالات WH172 وWH1366 وزيلج استغرقت وقتاً أقصر. مسافات الزراعة 3×3م نتج عنها زمناً أقصر من الإزهار وحتى الحصاد. السلالات WH172 وWH1366 وGN1824 أعطت أعلى إنتاجية بينما اعطت السلالة المحلية DC أقل إنتاجية. مسافات الزراعة 3×3م اعطت أعلى مكونات الإنتاج وأقل إنتاج كلي بينما أعطت مسافات الزراعة 2×2م أقل مكونات الإنتاج وأعلى إنتاج كلي نسبة للعدد الكبير من السبائط في وحدة المساحة. المواد الصلبة الذائبة الكلية كانت متقاربة في كل السلالات ولكن السلالات GN1824  و WH1366 أعطت  مذاقاً  أفضل من غيرها. مسافات الزراعة 2×3م و3×3م أعطت أعلى محتوى من المواد الصلبة الذائبة الكلية وافضل مذاق بالمقارنة مع  2x2 م. يوصى بزراعة  السلالات WH172  وWH1366 وGN1824 بمسافات  2×3م للحصول على أعلى انتاجية من الثمار ذات الجودة العالية

CYTOMEGALOVIRUS IgG AND IgM ANTIBODIES AMONG SUDANESE PATIENTS WITH ACUTE MYELOID LEUKEMIA: RELATION TO HEMATOLOGICAL PROGNOSTIC MARKERS

Background: Viral oncogenesis has remained an area of interest in cancer biology. Viruses have been great tutors of cancer biology, helping researchers to uncouple many signaling pathways and identifying critical therapeutic targets. Aim: The aim of this study was to assess the incidence of cytomegalovirus (CMV) infection and its impact on hematological prognostic markers of Acute Myeloid Leukemia (AML) among Sudanese populations. Method: The seroprevlance of CMV infection in AML patients was assessed in 100AML and 100 age and gender-matched controls. The associations of total white cell count and absolute blast count with the seroprevlance were examined. Results: The prevalence of CMV infection was 81% in patients and 17% in control subjects. Total white cell count and blast count were higher in AML CMV positive patients than AML CMV negative patients. Conclusion: Our findings indicate a high incidence of CMV infections in AML and its worse association with hematological markers could emphasize the role of CMV in the progression of AML. KEYWORDS: Acute myeloid leukemia; Cytomegalovirus

CYTOMEGALOVIRUS IgG AND IgM ANTIBODIES AMONG SUDANESE PATIENTS WITH ACUTE MYELOID LEUKEMIA: RELATION TO HEMATOLOGICAL PROGNOSTIC MARKERS

Background: Viral oncogenesis has remained an area of interest in cancer biology. Viruses have been great tutors of cancer biology, helping researchers to uncouple many signaling pathways and identifying critical therapeutic targets. Aim: The aim of this study was to assess the incidence of cytomegalovirus (CMV) infection and its impact on hematological prognostic markers of Acute Myeloid Leukemia (AML) among Sudanese populations. Method: The seroprevlance of CMV infection in AML patients was assessed in 100AML and 100 age and gender-matched controls. The associations of total white cell count and absolute blast count with the seroprevlance were examined. Results: The prevalence of CMV infection was 81% in patients and 17% in control subjects. Total white cell count and blast count were higher in AML CMV positive patients than AML CMV negative patients. Conclusion: Our findings indicate a high incidence of CMV infections in AML and its worse association with hematological markers could emphasize the role of CMV in the progression of AML. KEYWORDS: Acute myeloid leukemia; Cytomegalovirus

Doctor-Patient Communication A Requisite for Better Medication History Taking: Insight from Sudan

Despite the awareness of doctors about the significance of obtaining a comprehensive medication history for patients, they often neglect this in their practice, resulting in an incomplete patient medication list. The study aimed to investigate the role of communication skills as a crucial part of optimal pharmacotherapy. An observational, cross-sectional study was carried out at internal medicine department in a tertiary hospital, Wad Medani, Sudan.  The research instrument was a form involved a checklist rating a doctor’s performance during the medical encounters. Among 94 medical doctors, 51% were males and 6.15 (SE) was the average years of experience. About 13% of participants received under-graduation training in communication skills, while 21% had it after post-graduation. Concerning communication skills evaluation, 61% of specialists, 29% of registrars, and 7% of house officers reported an excellent performance. Gender and doctors’ ranking in a medical team had a significant role in communication skills (P-value <0.05) with an overall adjusted R2 of 0.339. Specialists were the most knowledgeable and skillful in obtaining structured medication history; 67% reported an excellent performance. Communication skills had a remarkable impact in getting patient medication history (P-value: <0.05) with an overall adjusted R2 of 0. 763.The study concluded that; gender and doctors’ ranking in the medical team were the main predictors for doctors to be a good communicator. Communication skills have a significant role in medication history taking. There was a gap in knowledge and training in communication skills among internal medicine doctors specifically, “house officers.” This gap negatively contributed to obtaining a comprehensive patient medication history

Basal-Like Phenotype in a Breast Carcinoma Case Series from Sudan: Prevalence and Clinical/Pathological Correlations

Basal-like breast cancer, an aggressive subtype associated with high grade, poor prognosis, and younger age, is reported frequently in Africa. We analyzed the expression of the basal cytokeratins (CKs) 5/6 and 17 in a case series from Central Sudan and investigated correlations among basal CK status, ER, PgR, and Her-2/neu, and individual/clinicopathological data. Of 113 primary breast cancers 26 (23%), 38 (34%), and 46 (41%) were, respectively, positive for CK5/6, CK17, and combined basal CKs (CK5/6 and/or CK17). Combined basal CK+ status was associated with higher grade (P < .03) and inversely correlated with ER (P < .002), PgR (P = .004) and combined ER and/or PgR (P < .0002). Two clusters based on all tested markers were generated by hierarchical cluster analysis and k-mean clustering: I: designated “hormone receptors positive/luminal-like” and II: designated “hormone receptors negative”, including both basal-like and Her-2/neu+ tumors. The most important factors for dataset variance were ER status, followed by PgR, CK17, and CK5/6 statuses. Overall basal CKs were expressed in a fraction of cases comparable to that reported for East and West African case series. Lack of associations with age and tumor size may represent a special feature of basal-like breast cancer in Sudan

Vitamin D and subsequent all-age and premature mortality: a systematic review

&lt;br&gt;Background: All-cause mortality in the population &#60; 65 years is 30% higher in Glasgow than in equally deprived Liverpool and Manchester. We investigated a hypothesis that low vitamin D in this population may be associated with premature mortality via a systematic review and meta-analysis.&lt;/br&gt; &lt;br&gt;Methods: Medline, EMBASE, Web of Science, the Cochrane Library and grey literature sources were searched until February 2012 for relevant studies. Summary statistics were combined in an age-stratified meta-analysis.&lt;/br&gt; &lt;br&gt;Results: Nine studies were included in the meta-analysis, representing 24,297 participants, 5,324 of whom died during follow-up. The pooled hazard ratio for low compared to high vitamin D demonstrated a significant inverse association (HR 1.19, 95% CI 1.12-1.27) between vitamin D levels and all-cause mortality after adjustment for available confounders. In an age-stratified meta-analysis, the hazard ratio for older participants was 1.25 (95% CI 1.14-1.36) and for younger participants 1.12 (95% CI 1.01-1.24).&lt;/br&gt; &lt;br&gt;Conclusions: Low vitamin D status is inversely associated with all-cause mortality but the risk is higher amongst older individuals and the relationship is prone to residual confounding. Further studies investigating the association between vitamin D deficiency and all-cause mortality in younger adults with adjustment for all important confounders (or using randomised trials of supplementation) are required to clarify this relationship.&lt;/br&gt