Sudan Medical Laboratory Journal

Detection of Candida spp.in Diabetic Septic Foot in Khartoum State Diabetic Center

Fri, 16 Dec 2022 00:00:00 +0000

Introduction: Diabetes mellitus is a chronic disorder that affects the immune system besides other systems and causes premature death or complications over time causing patients suffering. Because of immune system involvement, fungal infection is one of the prominent infections especially if patients present with wounds.

Material and method: 50 DM patients, 20 females and 30 males were enrolled. Double wound swabs were collected from each patient. 1st one is for direct microscopy (smear stained with 70% methylene blue). The 2nd one was used for culture in 3 test tubes containing Sabouraud Dextrose Agar, 2 test tubes were incubated aerobically (the 2 tubes used for confirmation).

Result: Candida spp. infection found among 9 (18%) patients and no Candida spp. infection among 41 (82%) of patients. Candida spp. infection found among elderly patients.

Conclusion: In this study, we were able to isolate Candida spp. from diabetic foot ulcer patients.

Vitamin D Receptors Gene Polymorphisms among Sudanese Patients with Prostate Cancer

Mon, 19 Dec 2022 00:00:00 +0000

Background: Prostate cancer has been most frequently diagnosed cancer in men in Sudan regarding to statistics data from the National Cancer Registry. Moreover, it was the second most prevalent cancer in men globally. BsmI, TaqI, FokI, and ApaI restriction enzymes are the most extensively investigated single nucleotide polymorphisms (SNP) in VDR, respectively, they are found in exon 2 (FokI), intron 8 (ApaI and BsmI) (TaqI).

Material and method: Study attempted to investigate the vitamin D receptor gene polymorphisms in Sudanese prostate cancer patients, this case control study included eight seven subjects they were split into two groups, cases group which included 42 prostate cancer patients who were identified by histology and control group which included 45 healthy individual as control. Data were collected by questionnaire and analyzed by statistical package for social sciences version (21) and SNP stat online web-based application program.

Results: Total of 87 individuals were included; 42 as case and 45 as control with age mean and median (71.78±8.04) and (70) respectively, rs731236, rs1544410 and rs2228570 SNPs has significant association between prostate cancer risk when compared with control group, contrary to this finding rs7975232 failed to find any associated with prostate cancer, furthermore all four SNP failed to find any associated with stage, Gleason grade, age, BMI, PSA level, and vitamin D levels.

Conclusion: The study concluded that polymorphisms of VDR gene have significant association with prostate cancer except ApaI SNP.

Association of Serum Calcium Level and Sodium Channel SCN1A Mutations with Idiopathic Epilepsy among Sudanese Patients

Fri, 23 Dec 2022 00:00:00 +0000

Background: Genetics research on humans has established that a genetic basis contributes to the susceptibility to epilepsy in a majority of cases. Al- Although many epilepsies are secondary to injury or another illness, approximately 40% are idiopathic, meaning that the original cause is unknown. It is presumed that most idiopathic epilepsies result from genetic abnormalities, with the majority likely caused by mutations in multiple currently unidentified genes. However, research has revealed a growing number of sin- gle-gene mutations that cause epilepsy.

Objective: To detect some of the genetic mutations which may cause idiopathic epilepsy.

Methods: The current study is a cross-sectional study that had been performed at Sheikh Mohamed Khair centre, Banat, Omdurman, and National Centre for Neurological Sciences (NCNS) Khartoum state, during the period 2016 to 2019. Ninety-nine participants were enrolled in this study. Demographic data were collected in a pre-designed questionnaire blood samples were analyzed for biochemical and molecular tests.

Results: Ninety-nine patients diagnosed with idiopathic epilepsy were recruited in this study. The most affected age group was 18 - 40 years accounting for 55% of patients. Females were the majority with 53%. Fifty per cent of the patients had their first seizure at the age of fewer than 5 years. Ni- ninety per cent of the patients have no Family history of epilepsy. All sequenced samples showed genetic mutations, deletion mutation was de-detected in 71% of the samples. Bioinformatics tools detected a frameshift mutation in the chain of amino acids.

Conclusion: The current study de- detected deletion mutations in the SCN1A gene (frameshift) that can cause epilepsy by changing some amino acids with residues that can affect neuronal stability indirectly.

Sero-pattern and Occupational Risk Factors Associated with Hepatitis B Virus Infection Among Health Care Workers at Wad Medani Teaching Hospital, Sudan

Mon, 19 Dec 2022 00:00:00 +0000

Hepatitis B virus (HBV) infection is a major public health problem worldwide. This cross-sectional study was conducted to detect the rate of HBV and risk factors among health care workers (HCWs) using different serological markers. Two hundred and fifty HCWs comprised physicians, lab specialists, nurses, employers, and wash workers. The HBV serological markers were analyzed using ELISA and Cobas411e. Out of 250 HCWs, 103 (41.2%) were males and 147 (58.8%) were females. HBsAg, HBeAg, HBeAb, and total HBcAb were detected in 2.8%, 2.0%, 4.4%, and 37.6% of study participants, respectively. Wash workers are the most vulnerable group, followed by employers and nurses. Furthermore, 115 (47.3%) HCWs were vaccinated and produced no HBsAg. The study spotlights to the positive impact of vaccination in reducing the prevalence of HBV infection, and also recommends the implementation of vaccination and hygiene policies to ensure a higher level of infection control.

The Utility of Serum Total and Placental Alkaline Phosphatase Activity as Predictive Markers for Preeclampsia among Sudanese Pregnant Women

Fri, 23 Dec 2022 00:00:00 +0000

Background: Serum total alkaline phosphatase (TALP) and placenta alkaline phosphatase (PALP) measurement can afford a simple, reliable and economical adjunctive laboratory parameter in hypertensive disorders of pregnancy.

Objective: To determine the utility of serum TALP and PALP as predictive markers for preeclampsia among Sudanese pregnant females.

Materials and Methods: Cross-sectional comparative hospital-based study conducted in Khartoum state at Omdurman Maternity Hospital from March to June 2022. Hundred Sudanese pregnant women aged ranged between (20 to 45 years), 50 pregnant women with preeclampsia and 50 normal pregnant women as a control group. The serum TALP, and PALP were measured using fully automated analyzer (response® 910), while serum urea, and uric acid were by enzymatic method and creatinine by chemical method. The data obtained were analyzed by using SPSS version (26).

Results: Preeclamptic women showed a significant increase in means of serum uric acid (7.4± 2.3 mg/dL VS 3.6± 1.0 mg/dL), urea (33.8± 4.0 mg/dL Vs 17.5 ± 6.2 mg/dL), PALP (151.5± 76.1IU/L VS 111.1±65.4 IU/L, P-value < 0.05) and the ratio of PALP/TALP (0.66 ±0.2 IU/L VS 0.52±0.1 IU/L, P-value< 0.05) compared to normal pregnant women. The Receiver operating characteristics curve (ROC) showed the optimum cut-off value of PALP >133 IU/L and ratio >0.589 as a predictor of preeclampsia among Sudanese pregnant women.

Conclusion: Sudanese women with preeclampsia had an elevated serum uric acid, urea, PALP and ratio of PALP/TALP. Moreover, PALP and the ratio of PALP/TALP can be used as a predictive marker of preeclampsia in pregnancy.

The Effects of Different Drugs Regimens in the Disease Activity Index and Uric Acid Levels of Sudanese Patients with Rheumatoid Arthritis

Ala’a E.A.E Eltahir, Osama S. Abbadi — Fri, 23 Dec 2022 00:00:00 +0000

Background: In Sudan, rheumatoid arthritis is treated with steroids and disease-modifying anti-rheumatic drugs (DMARDs). The typically used DMARDs include methotrexate, hydroxychloroquine (HCQ), sulfasalazine, and leflunomide.

Objective: In this study, authors assess the different drug regimens used in Sudan and their role in affecting the clinical disease activity index (CDAI) and serum uric acid (UA) of the patients.

Methodology: This was a comparative analytical case-control study enrolling 192 participants, (96) rheumatoid patients as cases and (96) non- rheumatoid as controls. Clinical disease activity index (CDAI) was performed on the patients, and venous blood samples, analyzed by automated spectrometry, were taken to measure the two groups of uric acid. Results were analyzed using Microsoft Excel 2013. A T-test was performed to assess the difference between two numerical means, and Analysis of variance (ANOVA) was used to assess the difference between three means or more. For categorical data, the Chi-square test was used.

Results: Only four patients were males (5%0) and the remaining 95% were females. The mean UA in males was 5.6 while in females it was 4.45, and the difference was significant (P=0.047). The difference between genders concerning the CDAI grading was insignificant (P=0.51). Lefulonodmide gave the highest rate of CDAI remission (67%) and the lowest serum UA mean (4.26.), while HCQ gave the least per cent of severe-high CDAI score (20%). The last-mentioned results were all statistically insignificant (P>0.05).

Conclusion: CDAI score was not correlated to specific drug regimens in Sudan. Further studies are needed to assess the drug regimens' effect in CDAI levels in Sudan.

Assessment of bone profile and Liver Enzymes among molecular subtypes breast cancer patients

Fri, 23 Dec 2022 00:00:00 +0000

Background: Some serum biochemical parameters may be used as prognostic markers of breast cancer; these are studied broadly, but not studied yet in Sudan.

Objective: in this study, we aimed to assess calcium, phosphate, Alkaline phosphatase (ALP), Gamma-glutamyl transpeptidase (GGT), and Lactate dehydrogenase (LDH) among hormone breast cancer subtypes.

Methods: In a comparative cross‑sectional 178 BC patients, ages ranging from 28 to 95 were randomly selected. Bone minerals and liver enzymes were measured using Mindray-BS-480 Clinical Chemistry Analyzer.

Results: In total, 30.3% were triple negative, were 69.7 % hormone receptor-positive, and 52.8% out of total was in the late stage. T. test analyses show a significant difference in GGT between triple-negative and hormone receptor-positive and also between late stage and early stage (P = 0.017 and 0.016, and 0.018), respectively.

Conclusion: Hormone receptor-positive and late-stage BC patients have increased GGT activity.

Serum Zinc and Copper Levels among Patients with Prostatic Cancer Attending National Cancer Institute, Gezira University, Sudan

Fri, 23 Dec 2022 00:00:00 +0000

Backgrounds: Prostate cancer is the most common cancer among Sudanese men and is equally distributed among its different tribes. Zinc (Zn) and copper (Cu) are one of the most important microelements and are ubiquitously present in the human body, and it is critical for maintaining prostate health and inhibiting prostate cancer development.

Objective: To assess serum zinc and copper levels among Sudanese prostatic cancer patients. Materials and Methods: A case-control study was carried out at National Cancer Institute from August 2020 to December 2020. The study included 60 Sudanese subjects, 30 of them were patients with prostate cancer and 30 were controls. The age of patients ranged between58-88. (43%) of patients were >70 Years and (57%) were <70 Years serum zinc and copper were measured by using atomic absorption spectrophotometer. Data were analysed using SPSS version (22).

Results: A highly significant decrease in zinc level in the case group (0.08±0.06) when compared with the control group (0.7±0.2) with p. value (p=0.000) and a highly significant increase in copper level in the case group (1.6±0.3) when compared with the control group (0.9±0.2) with p.value (p=0.000). There were no significant differences in Zn and copper levels according to age, BMI and duration with p. values (of 0.10, 0.70, 0.30), (0.28, 0.06, 0.52) respectively. Regarding Gleason stages patients with advanced stage,> score 7 (43%) (0.06±0.05) showed more decrease in zinc than patients with non-advanced stage ≤ score 7 (57%) (0.09±0.06) without significant differences (P=0.3) and showed more increase in copper than patients with non-advanced stage ≤ score 7 (57%) (1.47±0.50) without significant differences (P=0.37). There was a weak negative correlation between age, grade, stage and PSA with serum zinc with a coefficient r (-0.3, -0.03, -0.003, -0.2) respectively. While there was a weak positive correlation between BMI and duration with serum zinc with a coefficient r (0.07, 0.07) respectively. There was a moderate negative correlation between age, and duration with serum copper with a coefficient r (-0.20, -0.14). While serum copper had a moderate positive correlation with BMI, Stage, grade and PSA levels with a coefficient r (0.34, 0.28, 0.27, 0.27) respectively.

Conclusion: Serum zinc level in cases was lower than in controls; while serum copper level in cases was higher than in controls. The study recommended regular monitoring of serum zinc and copper in prostatic cancer patients.

Association of HBV genotypes with liver cirrhosis among HBV infected patients in Sudan

Mudathir Abdelshafea Abdelkareem Abakar, Shamsoun Khamis Kafi — Fri, 23 Dec 2022 00:00:00 +0000

Background:

The genome of HBV includes genetic variations arranged in ten genotypes, eight well-known genotypes labelled from A to H with two new genotypes called I and J. several studies suggest that the variations between HBV genotypes are closely associated with disease progression, treatment, and clinical outcome. This study aimed to associate HBV genotypes with liver cirrhosis among HBV-infected patients in Sudan.

Methods:

Ninety sera were collected from HBV-infected patients, 30(33.3%) of the participants were suffering from liver cirrhosis, and the rest were non-cirrhotic HBV patients as a control group. HBV genotypes were determined by PCR, and HBV viral load was estimated by real-time PCR. The concentration of AST and ALT was measured by a fully automated chemistry analyzer.

Results:

Genotype D is the most frequent genotype (94.4%) in this study population flowed by genotypes B(52.2%), A(20%), and E(1.1%). genotypes C, F, G, H, and I were not detected. Mixed genotypes were detected in most (60%) participants. Genotype D was the most frequent genotype (93.3%) among the cirrhotic group, and as well as showing the highest level of viral loads, AST and ALT.

Conclusion:

Genotype D is more associated with severe manifestations because it showed the highest levels of viral load, AST, and ALT. Genotypes B and B+D mixed infection are more probably associated with the development of liver cirrhosis in HBV infected patient, And genotypes B and D are more frequent among patients with liver cirrhosis regardless it was as a single genotype or mixed with other genotypes.

Correlation between Serum C-reactive protein Level with Severity of Covid19 Disease

Sat, 24 Dec 2022 00:00:00 +0000

Background: New coronavirus pneumonia (COVID-19) is a health emergency due to its high infectiousness and high case fatality in critically ill patients. C-reactive protein is one of the acute phase proteins and nonspecific markers of inflammation and has been found to correlate with disease severity and treatment of many infectious and non-infectious conditions.

Objective: To correlate the serum level of C-reactive protein among COVID-19 Patients with disease severity.

Materials and Methods: this analytical cross-sectional study, was conducted at Aliaa specialized hospital, Omdurman city, Khartoum state, during the period from January to March 2021. Fifty patients diagnosed with covid-19 using RT-PCR, were enrolled in the study and then classified into severe patients and non-severe patients The CRP was measured by Particle enhanced immunoturbidimetric assay in Integra 400 fully automated instruments. The data were analyzed using SPSS version (25).

Results: Out of fifty patients, 42 patients were the non-severe group, and the remaining eight patients were the severe group. The average age was 66.45 years (ranging between 30 and 120 years), and 54% of patients were males and 36% were females. The most common coexisting conditions were Diabetes Mellitus and hypertension; 60% of patients were having a Diabetes Mellitus, and 52% of patients were having hypertension. The study's findings indicated that the mean CRP level of severe group was considerably higher than that of the non-severe group (365.75± 209.378), with a p-value of (0.002) and the results of the correlation analysis revealing a strong positive link between the severity of the disease and CRP (r=0.419**, p=0.002).

Conclusion: serum C-reactive protein has been found to correlate with disease severity.

Cytomorphological Changes in Oral Mucosa as a Result of Cigarette Smoking in Wad Medani City, Gezira State, Sudan (2021)

Tue, 27 Dec 2022 21:36:08 +0000

Background: Smoking is a common practice and damages almost all organs and systems of the body. The oral cavity is rich in flora and contains many microorganisms that cause local and systemic diseases if microbiological flora is altered. Cigarette smoke renders oral mucosa epithelium to be susceptible to the colonization of pathogens. These pathogens can cause or contribute to the formation of systemic diseases.

Objectives: This study aimed to assess the cytomorphological changes in oral mucosa Duo to cigarette smoking using Pap stain and H&E stain, to find out the better staining results of the two colours, and to assess the effect of age, duration and frequency of smoking on the oral mucosa.

Materials and Methods: This study was a cross-sectional study to assess the cytological changes in oral mucosa of cigarette smokers using Pap stain in Wad Medani City, Gezira State, Sudan (2021). The study included 100 cigarette smokers’ samples. To avoid exposure to dry air, samples tacked by plastic sticks were spread on a slide and immediately fixed with fixative spray. In the pathology laboratory, the samples were stained with Papanicolaou and Hematotoxlin and Eosin. Each specimen had two slides, which were reviewed by a cytopathologist according to the criteria of benign and malignant.

Results: The mean age was 24 years. There was insignificant relation between the age of smokers and the cytological diagnosis of samples (P.Value 0.59), but most normal cases in less than 24 years and most typical cases in more than 24 years. There was insignificant relation between the duration of smoking and the cytological diagnosis of samples (P.Value 0.534), but most typical cases in more than 2 years of smoking.

There was insignificant relation between the frequency of smoking/day and the cytological diagnosis of samples (P.Value 0.190).

Conclusion: The mean age was 24 years. Cytomorphological changes in oral mucosa associated with presence of a typical mucosal cell in the age more than 24years old, and in smoking duration more than two years. There was insignificant relation between the frequency of smoking/day and presence of cytological changes in the samples. PAP stain was more sensitive and specific than H&E stain in the diagnosis of early malignant oral lesions.

Evaluation of Hematological Indices Changes in Response to Ramadan Fasting

Sat, 24 Dec 2022 00:00:00 +0000

Introduction: Fasting in the month of Ramadan is one of the five pillars of Islam. Fasting is obligatory for all adults and healthy Muslims during the day hours for the whole month every year. The effect of Ramadan on biochemical parameters is still a matter of debate. Several studies have reported the effect of Ramadan fasting on the values of certain haematological factors, and the impact of Ramadan fasting on various aspects of health, including lipid metabolism.

Objective: The study aimed to assess the impact of fasting on haematological parameters among Sudanese healthy adults male.

Materials and Methods: An experimental study was conducted between 27 May and 26 June 2017 (Ramadan of higri year 1438) in Khartoum state(Algerif East). The study was carried out on 20 healthy Sudanese volunteer subjects of aged between 18 to 45 years and with the same lifestyle, food intake and work. After informed written consent; all volunteers were asked to complete a medical test involving history taking, weight, height, and blood pressure were measured with standard techniques. Five ml of venous blood was collected by a standard procedure from each participant under complete aseptic conditions and putted in a test tube containing an anticoagulant (Ethyl diamine tetra acetic acid/EDTA). Blood samples were taken in 2 separate sessions on 1st and 2nd day before Ramadan which represented the baseline and during the last 3days of Ramadan At 10 pm. Blood samples were assessed for haemoglobin, Hematocrit, red blood cells count and indices, white blood cell count, differential white blood cells and platelets count. The data were analyzed using SPSS version (24).

Results: Hemoglobin and white blood cells significantly increased at the end of Ramadan (respectively=0.002, P=0.05). There was a direct correlation between haemoglobin and hematocrit significantly (P=0.000).

Conclusion: There was a significant increase in haemoglobin during Ramadan fasting, because most of the individual ate high or rich sources of iron (high biological value protein) and a rich source of vitamin C during Ramadan in comparison to other months of the year.

Comparative study of formal ether concentration, wet preparation, and zinc sulphate flotation techniques for intestinal parasite diagnosis. Omdurman State-Sudan

Sat, 24 Dec 2022 00:00:00 +0000

background. The faecal formal ether concentration technique has become a routine method as a part of complete parasite examination. It allows the detection of small organisms that may be missed by using zinc sulphate flotation and direct microscopy techniques.

Objective: The study aimed to compare between the reactivity of Formal ether, zinc sulphate flotation and direct microscopy techniques in detecting parasites ova, cysts, and larvae in the stool.

Material and Methods: This descriptive-based case study was conducted during the period from September to December 2021 in Ombada and Basher hospital in Omdurman - state. A total of 150 stool samples were collected and preserved in 10% formal saline. All samples were examined using wet preparation, Zinc sulphate flotation and formal ether concentration techniques.

Results. Out of 150 stool specimens examined, 104 cases were found to be positive in the deferments techniques used. The zinc sulfate flotation technique parasites detected was (28%), the formal ether technique parasites detection rate was (40%) and the wet preparation detection rate was (36%). The types of parasites detected in this study using different techniques were, E. histolytic (34%), Giardia lamblia 43.7%, Ascaris 0%, H. nana 33%, Taenia SPP 50% detected by formal ether technique, parasites detected by using wet preparation techniques were Giardia lamblia 31.3%, Ascaris 1%, Taenia SPP 50%, H. nana 33 % and E. histolytica 29%, Giardia. lamblia 25% was detected by using the Zinc sulphate technique.

Analysis of environmental Infection Control practices among TB laboratories in Khartoum state-Sudan

Ali Mohammedain Ali, Mubarak S Elkarsany Elkarsany — Tue, 27 Dec 2022 22:25:47 +0000

The tubercles laboratory, patient care settings require specific strategies directed at the prevention of transmission of diseases among health care workers and their patients.

Aim: The present study aimed to assess the knowledge, attitude and practice of infection control among TB laboratories in Khartoum state- Sudan

Materials and Methods:

A cross-sectional study using a structured distributed questionnaire was carried out including the key areas of infection control including Quality Control, personal protection, and environmental infection control.

Result

A total of sampling laboratories in Khartoum State in the study. Ten tuberculosis laboratories were visited. There was a collection area separate for TB samples collection and we found 50% only had a separate area for sputum sample collection.

Conclusion:

Assessment of environmental Infection Control practices Among TB laboratories The indicated that the standards of infection control was very low

Frequency of urinary tract infection among cancer patients receiving the chemotherapeutic drug at radiation and isotopes center of Khartoum (RICK)

Thu, 29 Dec 2022 22:06:05 +0000

Background: Chemotherapy often decreases the number of white blood cells in the body. White blood cells fight bacterial, fungal, and viral infections. Neutropenic patients, usually have their course of treatment interrupted and stopped unless blood cells return to normal. Despite the presence of infection, the burden and causes of this are not known.

Aims: Assess the risk of urinary tract infection among cancer patients receiving a chemotherapeutic drug. Also, evaluation of antibiotics used for treatment and the incidence of infection in males and females and among children

Methods: Fifty midstream urine (MSU) specimens were collected from patients who undergo chemotherapy treatment then specimens were analyzed to isolate bacterial pathogens, and evaluate antibiotics used for treatment.

Results: Out of 50 urine specimens investigated, 23 different isolates were recovered giving a percentage of (46%), and 27 urine specimens (54%) showed no growth. S. aureus (26.1%) followed by E.coli (21.7%), S. epidermidis (17.4%), K. pneumoniae (13%), p. mirabilis (13%), and Ps. aeruginosa (8.7%).

Conclusion: The most frequent isolate is S. aureus and E.coli. Females and adults were more infected than males and children respectively.