Adverse drug reactions of Intermittent chemotherapy compared to daily regimen in Sudanese patients with pulmonary Tuberculosis

Back ground: The World Health Organization (WHO) declared Tuberculosis a global health emergency in 1993 as it remains a major cause of mortality in developing countries. The World Health Organization's Directly Observed Treatment Short course (DOTs) strategy achieve 87% success rate in the areas where it is implemented, usually with five drugs, lasts for 6months. Till 1998 Sudan was classified as one of the slowly moving countries in implementation of the DOTS strategy and making no progress against tuberculosis.Objective: A prospective comparative, randomized clinical trial, hospital based study carried out at Kosti Teaching Hospital using directly observed treatment short course (DOTS), to assess the adverse drug reactions of intermittent chemotherapy compared to the currently adopted short coursetherapy.Methodology: Patients with smear positive new cases of tuberculosis were enrolled and randomized in to two groups, intermittent treatment group (A) and daily regimen group (B) .The raw data were introduced into SPSS program, the data comparison was carried out by Pearson Chi square and pair independent sample student T-test. The level of significance (P<0.05).Results: A total of 275 were studied, significant initial (pre-interventional) elevated means of aspartate aminotransferase (AST) was detected in the two groups and significantly in the intermittent regimen after two and four months, but the decrease was significant only after two months in the daily group.Conclusion: Liver injury following antituberculous treatment was minimal and the adverse drug reactions were tolerable concerning the majority of the patients completing the course of the treatment.Keywords: DOTS, INH, acetylators

On the generalized Hartley-Hilbert and Fourier-Hilbert transforms

In this paper, we discuss Hartley-Hilbert and Fourier-Hilbert transforms on a certain class of generalized functions. The extended transforms considered in this article are shown to be well-defined, one-to-one, linear and continuous mappings with respect to δ and Δ convergence. Certain theorems are also established

Effects of sugar beet root based concentrates level on carcass characteristics and body components in Tagger male kids

     Twelve Tagger male kids at 6 month old were used to study the effects of dried sugar beet root (DSBR) based concentrates level on the performance and carcass characteristics in the Gezira State, Sudan. They were weighed, divided into 3 groups according to body weight (BW) and allocated at random to the 3 experimental diets. They were  housed in individual pens and weighed weekly before the morning meal for 8 weeks with a two weeks preliminary period. They were fed groundnut haulm (GNH) ad lib. in two equal meals at 8 am and 4 pm and different levels of DSBR based concentrates (0 (control), 150g and 300g) in two equal parts before GNH meals. The animals were slaughtered and body components and carcass characteristics were studied. Slaughter weight, hot carcass weight (9.62- 12.69 kg), EBW (7.39-10.1kg), dressing percentages (37.26-41.67), muscle (65.75-68.0%), fat (7.75-12.25%), muscle: bone (2.49:1- 3.58:1) and muscle: fat (8.79:1-10.6:1) increased and bone (26.50 -19.75%) decreased with concentrates level. Body components weight and percentages on live BW varied among and within concentrate levels and were mostly the heaviest in animals fed 300g concentrates. Body components weights and percentages were not significantly (P>0.05) affected by concentrates level, except kidneys and renal fat, mesentery and omentum. The highest percentages were higher in the control and least in animals fed 150g concentrates. It is recommended to use DSBR based concentrates in fattening Tagger kids.     استخدم 12 ذكر جديان من  التقر بعمر 6 أشهر لدراسة أثر مستويات عليقة مركزة تحتوي على جذور بنجر السكر الجافة على  صفات الذبيحة و مكونات الجسم الثانوية في ولاية الجزيرة بالسودان.  تم وزن الحيوانات وتقسيمها الى 3 مجموعات على أساس الوزن ووزعت عشوائيا على اعلاف الدراسة الثلاث. وضعت الحيوانات في حظائر فردية ووزنت أسبوعياً قبل وجبة الصباح لمدة 8 أسابيع منها أسبوعين فترة إعدادية.  أعلفت الحيوانات تبن الفول السوداني حسب الرغبة في وجبتين متساويتين عند الثامنة صباحا والرابعة مساء و مستويات مختلفة من عليقة مركزة ترتكز على جذور بنجر السكر الجافة  (صفر (الشاهد) 150و و300جم ( في جزئين قبل وجبات تبن الفول السوداني.  ذبحت الحيوانات وقيست مكونات الجسم الثانوية وصفات الذبيحة. أظهرت الدراسة ازدياد وزن الذبح والذبيحة الحارة(9.62- 12.69  كجم ) ووزن الجسم الفارغ (7.39-10.1  كجم) ونسبة التصافي (37.26 %– (%41. 67  علي أساس الوزن الحي و  42.875-52.15%  علي أساس الوزن الفارغ ونسب العضلات (65.75  %- 68.00%) والدهون (7.75%-12.25%) ونسبة العضلات للعظام ( %2.49- %3.58 ) والعضلات للدهون 8.79%-10.6 (% و تقل نسب العظام (19.75%-26.50% (مع زيادة مستوي العليقة المركزة بدون فروق معنوية .  تباينت أوزان مكونات الجسم الثانوية ونسبها على أساس وزن الجسم بين وداخل مستويات العليقة المركزة وكانت أعلي في الحيوانات المغذاة علي 300 جم عليقة مركزة وأقلها في  مجموعة الشاهد . لم تكن الفروقات في أوزان ونسب مكونات الجسم الثانوية معنوية عدا الكلي ودهنها والمساريقا ودهن الأحشاء. كان عدد النسب المئوية الأعلى أكبر في مجموعة الشاهد واقل في التي أعلفت 150 جم عليقة مركزة. يوصي باستخدام علائق تحتوي على  جذور بنجر السكر الجافة لتسمين جديان ماعز التقر                                                                                           &nbsp

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 dried sugar beet root based concentrates level on wholesale cuts and eye muscle characteristics in Tagger male kids

Twelve Tagger males at 6 month old were used to study the effects of dried sugar beet root (DSBR) based concentrates level on animals performance, carcass and wholesale cuts characteristics. They were weighed and divided into 3 groups, each with 4 animals. They were housed in individual pens with feed and water troughs and allocated at random to the 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 am and 4  pm and different levels of DSBR based concentrates (0 (control), 150g and 300g) in two equal parts before GNH meals. The concentrates contained 68% DSBR,15% GNH cakes, 15% sunflower cake, 1% salt and 1% oyster shell. The animals were slaughtered, skinned and carcass characteristics were studied. The left side was divided into wholesale cuts and were weighed and dissected into muscle, fat and bone. The rib section (10th – 12th) was removed and the characteristics and meat composition were determined. Percentages of best end of neck, breast and leg and chump, neck and loin generally increased with concentrates level. Concentrates level had no significant (P>0.05) effect on wholesale cuts percentages. Meat DM, CP, EE and ash were 32.82%, 17.3%, 2.15% and 3.0% at 0 concentrates, 37.5%, 17.9%, 2.35% and 2.65, respectively at 150g concentrates and 35.5%, 18.2%, 2.4% and 2.95%, respectively at 300g concentrates. Overall meat composition was 35.28%, 17.8%, 2.3% and 2.87%, respectively. Meat DM and CP varied significantly (P<0.05) with concentrates level. Animals fed no concentrates had the least DM, CP and EE and the highest ash. Animals fed 300g had the highest CP and EE. Supplementing GNH with DSBR based concentrates generally improved Tagger kids wholesale cuts percentages and meat composition. It is recommended to use DSBR based concentrates in fattening Tagger kids.         حفز ارتفاع الطلب وأسعار اللحوم في السودان على تحسين لحوم الماعز لارتفاع أعدادها وارتفاع العضلات والقيمة الغذائية وانخفاض الكولسترول والأحماض الدهنية المشبعة.  تعتبر التقر سلالة واعدة لإنتاج اللحوم لجودة القوام ونوعية اللحم. إنتاج اللحوم عامة تقليدي مع انخفاض الاستثمار والعائدات. التغذية من أهم المعوقات لتدهور المراعي والتباين الموسمي في كمية ونوعية العلف وغلاء العلائق المركزة . أدخل بنجر السكر لولاية الجزيرة وهو علف واعد خاصة الجذر لارتفاع الطاقة. لا تتوفر معلومات عن استخدام جذر البنجر الجاف لجديان التقر.  ولذلك أجريت هذه الدراسة لاختبار اثر مستويات عليقة مركزة ترتكز على جذر البنجر الجاف على الأداء وصفات الذبيحة وتركيب اللحم في جديان التقر. وضعت 12 من ذكور جديان التقر بعمر 6  أشهر في حظائر فردية بها أوعية للعلف والماء وأعطيت عشوائيا الأعلاف  المختبرة. وزنت الحيوانات أسبوعيا لمدة 8 أسابيع منها أسبوعين فترة إعدادية. أعلفت الحيوانات تبن الفول السوداني حسب الرغبة في وجبتين متساويتين عند الثامنة صباحا والرابعة مساء ووزن العلف المتبقي. أعلفت الحيوانات مستويات مختلفة من عليقة مركزة ترتكز على جذور البنجر الجاف (صفر ( الشاهد)  150 و300جم ( في جزئين قبل وجبات تبن الفول السوداني . احتوت العليقة المركزة على 68% جذور البنجر الجاف و15%  امباز فول سوداني و15%  أمباز زهرة الشمس و1% ملح و 1% صدف.  حفظت عينات من تبن الفول السوداني و جذور البنجر الجاف والتبن المتبقي والعليقة المركزة للتحليل المعملي . ذبحت الحيوانات وسلخت  وفصلت مكونات الجسم الثانوية ووزنت لوحدها. وزنت الذبيحة وحسبت صفات الذبيحة.  قسم الجزء الأيسر من الذبيحة إلى قطع إجمالية ووزنت ثم شرحت كل منها.  فصلت العضلة العينية (الضلع 10-12 ) وعينت الصفات والتركيب .. قُسمت الذبائح لخمسة قطع تجارية ولم تُلاحظ فروق معنوية بين مستويات العلائق المركزة. عند التحليل الكيميائي للحوم كانت النسب المئوية للمادة الجافة و البروتين الخام والدهون الخام والرماد %32.82  و %17.3 و %2.15 و3.0  % للمجموعة القياسية و %37.5 و %17.9 و %2.35 و2.65 %عند 150 جم عليقة مركزة و  %35.5 و %18.2 و 2.4  2.95 % عند 300 جم عليقة مركزة ، علي التوالي. وكان المتوسط العام لتركيب اللحم %35.28 و %17.8 و2.3  %و %2.87 ، علي التوالي وكانت الفروق بين مستويات العليقة المركزة معنوية للمادة الجافة والبروتين الخام (P<0.05) . كان للمجموعة القياسية أقل مادة جافة وبروتين خام ودهون وأعلي نسبة رماد.  بينما نالت المجموعة المغذاة علي 300 جم عليقة مركزة أعلي بروتين خام ودهون.  عامة ساهمت إضافة تبن الفول السوداني والعلائق المركزة المعتمدة علي جذور بنجر السكر في تحسين نسب القطع التجارية وتركيب اللحم.  نوصي استخدام علائق بنجر السكر لتسمين جديان التق

Characterisation of Nicotine and Cancer-Enhancing Anions in the Common Smokeless Tobacco Afzal in Oman

Objectives: Afzal is a common smokeless tobacco product (STP) available illegally in Oman. This study aimed to assess pH and moisture levels and determine cancer-enhancing factors in a randomly selected sample of Afzal. Methods: This study was carried out at the Sultan Qaboos University in Muscat, Oman, between April and December 2013. A package of Afzal was purchased from a single provider and divided into samples. The pH and moisture content of the samples were measured according to the protocols of the Centers for Disease Control and Prevention. Gas chromatography-mass spectrometry was used to analyse nicotine levels and ionexchange chromatography (IC) was used to determine concentrations of nitrate, nitrite, chloride, fluoride, bromide, sulphate and phosphate anions. Results: The samples had an alkaline pH of 10.46 with high levels of total (48,770.00 μg per g of STP [μg/g]) and unionised (48,590.00 μg/g) nicotine. The concentration of nitrate (8,792.20 μg/g) was alarmingly high. The chloride concentration (33,170.80 μg/g) showed a surge on IC chromatography. The moisture content percentage was 52.00%. Conclusion: The moisture content percentage and chloride concentration of Afzal was consistent with those of other STPs. In contrast, nitrite, sulphate and phosphate concentrations were below reported levels of other STPs. All anion concentrations were below the maximum daily limit set by international health organisations. However, the high concentrations of nitrite, nitrate and nicotine and the elevated alkaline pH observed in the analysed Afzal samples suggest that STP users will face health risks as a result of their use

Efficacy of Semi-Rigid Ureteroscopy and Holmium:YAG Laser Lithotripsy in the Treatment of Ureteric Calculi, a Retrospective Study

Background: Urolithiasis is a common worldwide health problem. Many endosurgical treatments became available for urinary calculi.Objectives: To find out the success clearance and complication rates of ureteric stone treatment using semi-rigid ureteroscopy and Holmium:YAG laser lithotripsy as a day case procedure.Methods: In the period from April 2011 to October 2013, a total of 64 patients who were treated by laser lithotripsy were reviewed retrospectively using Fedail Hospital data. Diagnosis was radiologically confirmed. Semi-rigid ureteroscopy and Holmium:YAG laser lithotripsy was conducted as a day case surgery. Operative details, clearance of stone fragments, failure and complications were analysed. Cases were followed clinically and radiologically after one week and one month.Results: The studied cases were 47 males and 17 females with average age of 47.3 years and ASA I in 52(81.3%). Those who had left ureteric stones were 28(43.8%) patients, only one patient had bilateral stones and 60(93.8%) patients had single stones. The largest stone diameter was 1.9cm. 68.8% had distal ureteric stones, 14.1% had mid third stones, and 17.2% had upper third stones. Most cases 96.9% were operated under spinal anaesthesia with mean operation time 61.2 minutes. Seven patients needed VUJ balloon dilatation to get access to the ureter.20 watt Holmium:YAG laser fibres were used for stone disintegration. 92.2% of cases had uncomplicated clearance, 3.1% minor complications and 4.7% failure of the procedure.100% clearance was confirmed during follow up. Conclusion: Semi-rigid ureteroscopy and Holmium:YAG laser lithotripsy is a safe treatment for ureteric calculi and can be conducted as a day case with high success rate and very low morbidity.Key words: ureteric stone, Semi-rigid ureteroscopy, Holmium:YAG laser lithotripsy

Mycobacterium avium subsp. paratuberculosis Virulence: A Review

To propose a solution for control of Mycobacterium avium subsp. paratuberculosis (MAP) infections in animals as well as in humans, and develop effective prevention, diagnostic and treatment strategies, it is essential to understand the molecular mechanisms of MAP pathogenesis. In the present review, we discuss the mechanisms utilised by MAP to overcome the host defense system to achieve the virulence status. Putative MAP virulence genes are mentioned and their probable roles in view of other mycobacteria are discussed. This review provides information on MAP strain diversity, putative MAP virulence factors and highlights the knowledge gaps regarding MAP virulence mechanisms that may be important in control and prevention of paratuberculosis

Multivariable regression analysis in Schistosoma mansoni-infected individuals in the Sudan reveals unique immunoepidemiological profiles in uninfected, egg+ and non-egg+ infected individuals

Background: In the Sudan, Schistosoma mansoni infections are a major cause of morbidity in schoolaged children and infection rates are associated with available clean water sources. During infection, immune responses pass through a Th1 followed by Th2 and Treg phases and patterns can relate to different stages of infection or immunity. Methodology: This retrospective study evaluated immunoepidemiological aspects in 234 individuals(range 4–85 years old) from Kassala and Khartoum states in 2011. Systemic immune profiles(cytokines and immunoglobulins) and epidemiological parameters were surveyed in n = 110 persons presenting patent S. mansoni infections (egg+), n = 63 individuals positive for S. mansoni via PCR in sera but egg negative (SmPCR+) and n = 61 people who were infection-free (Sm uninf). Immunoepidemiological findings were further investigated using two binary multivariable regression analysis. Principal Findings: Nearly all egg+ individuals had no access to latrines and over 90% obtained water via the canal stemming from the Atbara River. With regards to age, infection and an egg+ status was linked to young and adolescent groups. In terms of immunology, S. mansoni infection per se was strongly associated with increased SEA-specific IgG4 but not IgE levels. IL-6, IL-13 and IL-10 were significantly elevated in patently-infected individuals and positively correlated with egg load. In contrast, IL-2 and IL-1β were significantly lower in SmPCR+ individuals when compared to Sm uninf and egg+ groups which was further confirmed during multivariate regression analysis. Conclusions/Significance: Schistosomiasis remains an important public health problem in the Sudan with a high number of patent individuals. In addition, SmPCR diagnostics revealed another cohort of infected individuals with a unique immunological profile and provides an avenue for future studies on non-patent infection states. Future studies should investigate the downstream signalling pathways/mechanisms of IL-2 and IL-1β as potential diagnostic markers in order to distinguish patent from non-patent individuals