Rare Presentation of Wilson Disease in an 11-year-old Sudanese Girl

Background: Wilson disease is an inherited disorder in which excessive amount of copper accumulates in various tissues of the body. Clinical features related to copper deposition in the liver may appear in the first and second decades followed by neurologic and psychiatric thereafter; however, many patients have a combination of these symptoms. Case: We report a case of 11 year-old girl, admitted to Wad Medani Pediatric Teaching Hospital with generalized body swellings for four days. Initial investigations showed proteinuria and hypoalbuminemia, thought to be due to nephrotic syndrome. Days later, patient developed jaundice and neuropsychiatric manifestations. A slit lamb examination confirmed the presence of Kayser–Fleischer ring (KF ring) and she scored high in the scoring system for the diagnosis of Wilson disease. Dpenicillamine treatment therapy was started and unfortunately the patient’s clinical condition deteriorated gradually, and eventually went into deep coma and died. Wilson disease mainly affects the liver, but the initial presentation was completely compatible with nephrotic syndrome. Conclusion: Diagnosis of Wilson disease should be suspected in a child presenting with generalized body swellings even in the absence of clinical evidence of hepatic and/or neuropsychiatric involvements

Sero-molecular Epidemiology of Hepatitis E Virus in Blood Donors, Gezira State, Sudan: A Cross-sectional Study

Background: Hepatitis E virus (HEV) is a hepatotropic pathogen that causes significant morbidity and mortality in humans. It is an important causative agent of viral hepatitis outbreaks. This study investigates the serological and molecular prevalence of HEV in blood donors attending the Central Blood Bank in Wad Medani City in Gezira State, Sudan. Methods: The study adopted a cross-sectional descriptive design. A structured questionnaire was used to collect data concerning demographic information and risk factors associated with HEV transmission. All enrolled participants (N = 300) were screened for HEV IgG antibodies using commercial ELISA kits, then strong positive samples (N = 84) were selected and rescreened for HEV IgM and HEV RNA by RT PCR. SPSS version 24.0 was used for analysis. Results: Out of 300 male participants, 36.3% (109/300) were positive for HEV IgG. However, only one participant was IgM positive, while the HEV RNA was negative. The highest prevalence rates of the virus were 42 (44.6%) among the age group of 31–40 years, 20 (48.8%) in those who consumed food from outside, 13 (50%) in three to four multiple blood donations, and 5 (62.5%) in those who consumed water from the river source. A significant association of HEV IgG prevalence concerning the occupation of the participants being students or farmers was detected using univariate and multivariate analysis (P-value = 0.007). Conclusion: High prevalence of HEV IgG was demonstrated among the healthy blood donors in this study. Given the possibility of HEV transmission by transfusion from donors to recipients, we recommend that routine screening for HEV should be adopted by blood banks in Sudan

Knowledge and attitudes toward COVID-19 vaccination in Sudan: A cross-sectional study

Background: Vaccines are an essential part of public health interventions to mitigate the devastating health and non-health impacts of COVID-19 pandemic. Despite the fact that Sudan launched the COVID-19 vaccination program in March 2021, only 10% of the population received their two primary doses of vaccines by the end of May 2022. This delayed uptake of vaccines obviously warrants investigation. Therefore, we have conducted this study to evaluate the knowledge, attitude and acceptance of the general population in Sudan toward COVID-19 vaccines. Methodology: A descriptive cross-sectional community-based study. The data were collected using an electronic questionnaire from 403 individuals living in Khartoum, Sudan. The data were processed using the Statistical Package for Social Sciences (SPSS), and data analysis was performed using appropriate tests. Results: 51% of the participants were found to have sufficient knowledge about the COVID-19 vaccine, and the knowledge level is higher among those educated beyond the secondary school and those who were employed. Among those unvaccinated, only 47% of the participants expressed their intention to take the vaccine when offered to them. The major reason for not trusting the vaccine is safety concerns expressed by 65.5% of the unvaccinated. Conclusion: Higher education levels and employment were associated with an increase in sufficient knowledge about the vaccine in around half of the participants. However, most of participants had not taken the vaccine at the time of the study, and the trust in vaccines is not high. Effective interventions by the health authorities are needed to address these issues in order to accelerate the COVID-19 vaccination program in Sudan

Intonation in Iraqi Musical Melodies

Abstract This paper deals with intonation in Iraqi musical melodies (MMs). As such, it aims to analyze the intonational patterns in the Iraqi music. The main musical melodies in the Iraqi music are this vein, the current study attempts to answer the following questions: the current paper attempts to answer the following questions: (i) what are the intonational patterns of Iraqi MMs? And (ii) what is the additional function of intonation in MMs? In the light of these questions, the corner hypothesis is that Iraqi MMs have their own specific definable intonational patterns. On the basis of the analysis, it is concluded that intonation can be a useful tool for analyzing musical variations in the basic Iraqi MMs. Moreover, musical intonation, which is the task of musicologists, is accompanied by phonological intonation t

Extraction of Zn (II) and Cu (II) Ions UsingPEG (300) - KCl Salt Aqueous Two-Phase Systems

In this paper the process of metal ions extraction (Zn(II) and Cu(II)) was studied in PEG-KCl aqueous two phase system was investigated without using an extracting agent. The experimental runs were performance at constant temperature (25 oC), constant mixing time (30 min), and constant PH of the solution (about 3). The effect of KCl salt concentration (from 10% to 25%), volumetric phase ratio of PEG solution to KCl solution (from 0.5 to 2), and the initial metal ion concentration (from 0.25 ml to 2 ml of 1 gm/L solution) were investigated on the percent extraction of Zn(II) and Cu(II). The results indicated that the percent extraction of metal ions increase with increasing of salt concentration and phase ratio, and slightly decrease with increasing of initial metal ion concentration

Utilization of steel-making dust in drilling fluids formulations

Steelmaking is an energy-intensive process that generates considerable amounts of byproducts and wastes, which often pose major environmental and economic challenges to the steelmaking industry. One of these by-products is steel dust that is produced during the separation of impurities in the smelting and refining of metals in steel-making furnaces. In this study, electric arc furnace (EAF) dust has been evaluated as a potential, low-cost additive to increase the viscosity and weight of drilling muds. Currently, the cost of drilling operations typically accounts for 50 to 80% of the exploration costs and about 30 to 80% of the subsequent field development costs. Utilization of steelmaking waste in drilling fluids formulations is aimed to produce new and optimized waterbased drilling formulations, which is expected to reduce the amount of bentonite and other viscosifier additives used in the drilling formulations. The results showed that in a typical waterbased drilling fluid of 8.6 ppg (1030.51 kg/m3), the amount of standard drilling grade bentonite could be reduced by 30 wt. % with the addition of the proposed new additive to complete the required mud weight. The mixture proved to be stable with no phase separation.Scopu

Histopathological Features of Whipple Pancreaticoduodenectomy in Sudan: A Single-center Experience

Background: Periampullary tumors (PATs) are rare and Whipple pancreaticoduodenectomy is the commonest surgical approach for its management. The aim of this study was to analyze the histopathological features of Whipple-resected periampullary tumors in Sudanese patients.   Methods: This retrospective descriptive study included 62 cases of Whipple resection seen in a center in Khartoum, Sudan from January 2016 to June 2021. The specimens were assessed for nine features of the tumor: site of the tumor (whether within the periampullary region), size of the tumor, histological type of the tumor, grade, perineural invasion, lymph vascular invasion, surgical margin status, lymph node metastasis status, and the pathological stage (pTNM). Results: In total, 62 cases, 40 (64.5%) males and 22 (35.5%) females, were included. Age ranged from 20 to 90 years with a mean age of 56.08 years (±12.98 SD). Of the 62 cases, 58 were malignant (93.5%), while 4 cases were benign (6.5%). The pancreas was the commonest site for malignant tumors (53.4%), followed by the ampulla (24.1%), duodenum (15.5%), and distal common bile duct tumors (DCBD) (7%). The maximum tumor size was 8 cm, and the number of lymph nodes resected ranged from 3 to 33. Pancreatic ductal adenocarcinomas (PDACs) showed the highest percentage of perineural (62.1%) and lymphovascular (55.2%) invasions, and a positive margin was seen in four cases. The most common tumor stage was pT3pN1pMx. Conclusion: PATs in the Sudanese population showed histological diversity regarding subtyping, grading, and staging. Further studies involving molecular prognostic features will support improving patient management

Effect of electrolytes on electrokinetics and flocculation behavior of bentonite-polyacrylamide dispersions

© 2018 Elsevier B.V. In this study, the influence of electrolytes on bentonite dispersions flocculated with different polyacrylamides varying in charge type, density and molecular weights has been investigated. The presence of electrolytes was found to induce profound impact on the flocculation behavior of bentonite-polyacrylamide dispersions, which was analyzed by means of residual turbidity, zeta potential and floc size distribution tests. Electrolytes enhanced the adsorption of anionic polyacrylamide chains on negative bentonite surface, while hindering adsorption of cationic polyacrylamides. Electric double layer compression and mediated flocculation by metal cations were the principle mechanisms involved in the improvement of flocculation behavior. High molecular weight and charge density variants greatly reduced the turbidity and negative zeta potential of dispersions for anionic polyacrylamides. Furthermore, charge density of metal ions was found to be a determining factor. Divalent salts were more efficient for flocculating dispersions using anionic polyacrylamides, while monovalent salts were preferable for cationic polyacrylamides owing to electrostatic repulsions. Amphoteric polyacrylamides displayed similar results based on their anionic/cationic nature. Similar observations were recorded for floc size measurements. High charge density variants of anionic polyacrylamides in the presence of divalent salts like CaCl2 produced large flocs. On the other hand, no significant changes in floc sizes were observed for cationic polyacrylamides in the presence of salts. Overall, this study successfully determines the effect of electrolytes on the flocculation behavior of bentonite dispersions

Conservative management of intraventricular migrating intracranial bullet: A case report

Background. The high mortality rate of a cranial bullet injury, the catastrophic damage of vital tissue, and the frequency of gunshot accidents made managing such cases highly effortful in neurosurgical trauma centres. One category of these injuries is the gravitational bullet injury, in which the bullet's movement depends on gravity after losing its kinetic energy. This paper aims to describe the conservative treatment plan we applied for a patient who suffered an intracranial gravitational bullet injury. Case description. The patient presented with a cranial bullet injury that migrated caudally to his lateral ventricle. This unapproachable location of the bullet made the surgical intervention undoable. Therefore, after the implication of resuscitative management, the patient went under heavy observation with a suitable follow-up plan. The patient's short-term outcome was excellent, and his Glasgow coma scale was 15 at the discharge. Conclusion. Conservative management in a gravitational bullet is one of the possible methods to reach the best outcome in non-operable patients. Such measures are highlighted in this case, even when a complication like a bullet migration may occur