Sudanese Patient Research Articles

Fulminant guillain barre syndrome associated with bartonella hensle infection in a sudanese patient - Rare and fatal case

Fulminant guillain barre syndrome associated with bartonella hensle infection in a sudanese patient - Rare and fatal case

Retinal changes in cerebral malaria among sudanese patient in Khartoum State, Sudan

It is thought that Malaria parasites live in red blood cells and make them stick to the inside of small blood vessels, particularly this causes the unique whitening of eye blood vessels. The light-sensitive tissue in the eye is also affected because the parasites disrupt the supply of oxygen and nutrients These changes, known as malarial retinopathy, include white, opaque patches, whitening of the infected blood vessels, bleeding into the retina and swelling of the optic nerve. Our study aims to demonstrates malarial retinopathy in patients presented with neurological manifestations of malaria. A cross-sectional Hospital based study included all patients with malaria seen during the period between 1-1-2019 and 25-4-2019. Almost 40 patients with neurological manifestations of malaria were included in the study (29 having cerebral malaria, 3 with post malarial cerebellar ataxia, 2 with post malarial syndrome and abnormal movement, one with peripheral neuropathy, one with proximal myopathy, one had cerebral infaction, one had cerebral haemorrhage, one had sagital sinus thrombosis and one had six nerve palsy). Out of 29 patients with cerebral malaria 14 were children and 15 were adult. Malarial retinopathy changes were detected only among those with cerebral malaria (7 children and 3 Adult). The eye can provide a very reliable way of diagnosing cerebral malaria. By looking at the changes to the retina Our research demonstrates that the detection of malarial retinopathy is a much needed diagnostic tool in cerebral malaria, and can identify those children at most risk of death.

Clinical and Ultrastructural Studies of Gelatinous Drop-Like Corneal Dystrophy (GDLD) of a Patient with TACSTD2 Gene Mutation.

Purpose To describe clinical, molecular genetics, histopathologic and ultrastructural findings of gelatinous drop-like corneal dystrophy (GDLD) (OMIM #204870) in a Sudanese patient. Method An ocular examination revealed the onset of GDLD in a Sudanese patient (50 years old) at King Khalid Specialist Hospital, Riyadh. The 333 sequence variants in 13 GDLD genes of a DNA sample were screened by Asper Ophthalmics Ltd. It was further confirmed by sequencing. The patient had undergone a penetrating keratoplasty in the right eye. The corneal tissue was processed for histopathology and ultrastructural studies. Results Slit-lamp observation showed grayish-white multiple superficial corneal nodules of various sizes in the left and right eye. Both corneas became clear after the surgery. The GDLD deposits in the subepithelial region and in the anterior stroma were confirmed by PAS staining and their apple-green birefringence under polarized light. Ultrastructurally, the amyloid fibrils were very thin and grouped in whorl-like structures, which caused splits between and within the stromal lamellae. Collagen fibrils (CFs) and keratocytes had degenerated. A homozygous c.355T > A mutation in exon 1 of the TACSTD2 (M1S1) gene was detected, and alteration of the amino acid (p.Cysl19Ser in NCBI entry NP_002344.2) was observed. Conclusion In our patient with GDLD, a “c.355T > A” mutation in exon 1 of TACSTD2 was detected and believed to be responsible for the alteration of the amino acid leading to the formation of the amyloid deposits. The deposits caused the ultrastructural degeneration of epithelium, Bowman's layer, stroma, and keratocytes of the GDLD cornea.

Evaluation of plasma zinc and copper in patient with chronic renal failure in Khartoum State - Sudan

The kidney is complex vital organs, and has many functions. The main function it‘s removal of toxic and excess substancesfrom the plasma, if there is any defect in the kidney like renal failure can disrupt this function. The aim of this study was to determine the level of Zinc and Copper in Sudanese patient with chronic renal failure. This study was designed as case control, which includes 100 blood samples, a 60 from these sample were collected from patient with chronic renal failure and 40 samples were collected from health individual as control group and the sample is collected by using sterile disposable syringes and separated by centrifuge. Carried out in Ribat University Hospital in Khartoum state, during period from March to June 2018. And the plasma levels of zinc and copper determined by the use of atomic absorption spectrophotometer (OPERATOR’S MANUAL January 2003 VER 3.94 C), and the obtained results were analyzed by SPSS. The result of this study showed that there was significant decrease (p<0.05) in the plasma levels of zinc and copper in patient with chronic renal failure compared to the control subjects. The mean of plasma Zn was 0.3mg/l in test group and 0.7mg/l in control group with p. value of 0.002 and the mean of plasma Copper was 0.5mg/l in test group and 0.7mg/l in control group with p. value of 0.019. Also the study showed the gender and age of the patient, also the duration of the disease have no effect on the plasma level of zinc and copper (p 0.05). The study concludes that the plasma level of zinc and copper are low in patient with chronic renal failure. And the gender and age of the patient also the duration of disease have no significant effect on the plasma level of zinc and copper.
 Keywords: Chronic Renal Failure, Zinc, Copper, Sudanese

Antibody Affinity, Total Antibody Activity, and Protein Content to Anti-HBs Antigen Among Sudanese and Chinese Using Terminal Antibody Method.

Generally, HBV infection serum markers have been globally measured, and the analysis of entire an-tibody details include the affinity, total protein content and antibody activity are rarely measured between two different ethnic groups. We detected and determined the entire characteristics of anti-HBs (antibody to HBs anti-gen) among Sudanese and Chinese HBV resolved patient's using a terminal antibody (TA) method. Serum samples of Sudanese and Chinese resolved HBV infection positive anti-HBs were collected. All se-rum samples were diluted in serial dilutions (20, 40, 80, and 160 dilutions). Anti-HB markers were measured with enzyme-linked immunosorbent assay (ELISA), antibody affinity, total protein content, and total antibody activity to anti-HBs were calculated according to the results obtained for each dilution. The antibody affinity to HBV statistically showed higher significance among Sudanese than Chinese (p < 0.05). The total antibody activity to HBV among Sudanese was higher statistically than Chinese patients (p < 0.05). Statistically, there was a high correlation between age and antibody affinity to HBV among Sudanese compared to the Chinese group (p < 0.05). The measurement of the antibody affinity, total antibody activity, and protein content of anti-HBs among Sudanese and Chinese, two different ethnic groups, may predict HBV infection status among African race and Asian race, and in addition, may play an important role in a high or a low incidence of the disease between different ethnicities.

EVALUATION THE EFFECT OF THE MALARIA PARASITE ON PROTHROMBIN TIME AND ACTIVATED PARTIAL THROMBOPLASTIN TIME LEVELS AMONG SUDANESE PATIENT IN KHARTOUM STATE- SUDAN.

24Sep 2018 EVALUATION THE EFFECT OF THE MALARIA PARASITE ON PROTHROMBIN TIME AND ACTIVATED PARTIAL THROMBOPLASTIN TIME LEVELS AMONG SUDANESE PATIENT IN KHARTOUM STATE- SUDAN. Sarah Mahmoud Abdabagi , Fayhaa Mohammed Altayeb , Ahmed BakheetAbdAlla , RaniaAbdAlrhaman Osman and Ali ElaminNasir. Department of Hematology and Immunohematology, College of Medical Laboratory Science, Sudan University ofScience and Technology, Khartoum, Sudan. Head Department of Parasitology and Medical Entomology, College of Medical Laboratory Science, Sudan University of Science and Technology, Khartoum, Sudan. Department of Parasitology and Medical Entomology, College of Medical Laboratory Science, Sudan University of Science and Technology, Khartoum, Sudan.

Anti-VGKC-antibody mediated limbic encephalitis in a Sudanese patient: Rarity in sub Saharan Africa

Anti-VGKC-antibody mediated limbic encephalitis in a Sudanese patient: Rarity in sub Saharan Africa

Estimation and Assessment of D-Dimer Levels in Sudanese Patients with Pulmonary Tuberculosis

Background: The association between pulmonary tuberculosis and a hypercoagulable state is well documented. An increased D-dimer level is linked with increasing the mortality of pulmonary tuberculosis infection. Objective: The current study aimed to the estimation and assessment of the D-dimer levels in Sudanese patients with pulmonary tuberculosis. Material and Methods: This is a case control study that was conducted during March 2016 at Faculty of Medical Laboratory Sciences, Alneelain University, Khartoum, Sudan. A total of 70 subjects were included in this study, classified into two groups. The first group consists of 40 subjects, among which 30 (75%) were males and 10 (25%) were female; their mean age is 32.3 years classified as patients group; of other 30 normal healthy subjects, 15 (50%) were female and 15 (50%) were males; their mean age was 33.1 years in the second group as normal control group. The platelet poor plasma was prepared immediately from citrated blood by centrifuging at 2000 rpm for 15 minutes. The data were collected by structured interview and questionnaire, and then analyzed by using a computer program statistical package for social sciences (SPSS) version 21. The D-dimer levels were measured using immunometric assay (Nyco Card READER II). Result: The present study found that the D-dimer levels were statistically significantly higher in pulmonary tuberculosis patients compared to the normal healthy control groups (Mean ± SD 0.82 ± 0.54 vs. 0.33 ± 0.13 with p value 0.00). Conclusion: This study showed that Sudanese patient with pulmonary tuberculosis has increased the plasma D-dimer level, and this abnormality could be prone to Deep Vein Thrombosis (DVT).

Absence of Simian virus 40 DNA in salivary glands among Sudanese patients with Pleomorphic adenoma

Background: Pleomorphic adenoma is a common benign salivary gland neoplasm characterized by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality is the commonest benign tumor to arise in the minor salivary gland. Simian virus 40 (SV40), is a highly oncogenic DNA tumor virus (polyomaviridae) which was recently found to be associated with various human tumors including pleomorphic adenoma. The virus is a monkey virus which was believed to be transmitted to humans only under exceptional situations. Objective: The aim of this study was to evaluate the presence of SV40 DNA among Sudanese patient with pleomorphic adenoma of the salivary glands. Material and Method: This is a case control study was conducted at Khartoum state, during period 2006-2012. Thirty study samples represents as cases that had salivary gland pleomorphic adenoma and ten normal salivary gland tissues represent as controls. Qualitative polymerase chain reaction (PCR) was used to evaluate the presence of SV40 DNA. Results: In this study, human pleomorphic adenoma (PA) of salivary gland specimens and normal salivary gland tissues used as control were analyzed by qualitative polymerase chain reaction (PCR) for SV40. All sample (case and control) Tissue specimens were SV40 negative. Conclusion: The findings of this study showed the absence of SV40 DNA in salivary and did not indicate any role among patients with PA.

Thyroid Dysfunction in Epileptic Children and Association with Antiepileptic Drugs in Sudan

There are limited and conflicting data about the effect of antiepileptic drugs on thyroid gland in children. The objective of this study to investigate the effects of TSH and thyroid hormone in children receiving the valproate, carbamazepine. Cross sectional case control study was conducted at omdurman children hospital which is general pediatrics hospital with many referred clinics including neurology clinic, ahmed gasam children hospital is general pediatrics hospital, Abraham malak hospital during the period from March to May 2015. In this study 100 children Sudanese patient have epilepsy and receiving, antiepileptic drugs for at least 1 years and diagnosed as epileptic based on EEG (case) and 50 sudanese children as (control). The study showed that children use carbamazepine drugs there was significant increase in mean concentration of TSH comparison with control groups with p-value 0.000 and significant decrease in mean concentration of T4 comparison with control groups with p-value 0.000 and significant minor decrease of T3 comparison with control groups with p-value 0.002 , and children use valporate group showed was significant increase in mean concentration of TSH comparison with control groups with p-value 0.000 and significant decrease in mean concentration of T4 comparison with control groups with p-value 0.000 and significant normal of T3 comparison with control groups with p-value 0.000. Our data suggest that all antiepileptic drugs studied had varying degrees of deleterious effects on thyroid function.

Any possible association between Behcet's disease and retinitis pigmentosa

Behcet's disease is a rare multisystem disease; it has many ocular features, and it is not known to be associated with dystrophic conditions such as retinitis pigmentosa (RP). This is a case report of a Sudanese patient with Behcet's disease with ocular features and RP. A 28-year-old female with nyctalopia, skin hyper-pigmentation, and oral and genital ulcers was diagnosed as RP with Behcet's disease. She received a high dose of steroids and Azathioprine. She developed bilateral cataract and glaucoma. Pathergy test is negative. The patient is fulfilling the diagnostic criteria of both RP and Behcet's diseases. Behcet's disease is a rare condition; it is not common among Sudanese patients, and it has not been known to co-exist with RP.

Successful pregnancy after breast cancer treatment in a Sudanese patient

Breast cancer survivors, usually, suffer many side-effects from cancer treatments such as premature menopausal symptoms, osteoporosis, and infertility. We report a case of a pregnancy in a Sudanese patient after amenorrhea as a result of breast cancer chemotherapy treatment. A 34-year-old female with a history of right breast lumpectomy presented to the National Cancer Institute, Gezira University, Sudan with reoccurred malignant breast tumor. The patient underwent treatment that included the mastectomy, axillary clearance, followed by anthracycline-based chemotherapy for 4 months and then tamoxifen. However, whereas, on treatment, the patient developed amenorrhea as a side-effect of chemotherapy treatment. Despite this, the patient became pregnant and delivered full-term twin babies with no congenital abnormalities. Temporary chemotherapy treatment-related menopause may occur in younger women and factors such as chemotherapy drug type, dosage, and the patient's age may play a role.

Gelatinous drop like dystrophy (GDLD) in a Sudanese patient

AbstractPurpose Gelatinous drop‐like corneal dystrophy (GDLD) (OMIM #204870) is an early‐ onset, autosomal recessive corneal dystrophy, reported globally. It presents in the first decade of life with bilateral, mulberry‐like or gelatinous lesions, due to amyloid deposition in the superficial cornea.Methods A 50 year old Sudanese patient was diagnosed for GDLD. The patient had penetrating keratoplasty in the right eye. The tissue was processed for light and electron microscopy. A DNA sample was screened for 333 sequence variants in 13 corneal dystrophy genes by Asper Ophthalmics Ltd, followed by confirmatory sequencing.Results The GDLD cornea contained deposits of amyloid fibrils at the sub‐epithelial region and in various parts of stroma. The deposits were Congo red positive and showed apple green birefringence under polarized light. The growth of amyloid fibrils was associated with large splits between lamellae, a reduced diameter of collagen fibrils and degeneration of keratocytes. A homozygous c.355T&gt;A mutation in exon 1 of the TACSTD2 (M1S1) gene was identified, not present in dbSNP, predicted to cause a pathogenic amino acid change (p.Cysl19Ser in NCBI entry NP_002344.2).Conclusion The cornea of this GDLD patient with a novel c.355T&gt;A mutation in exon 1 of TACSTD2 showed degeneration of the corneal epithelium, Bowman’s layer, stroma and keratocytes. Deposits of amyloid were found in the sub‐epithelium region, Bowman’s layer, and stroma. Acknowledgement: Supported by National Plan for Science and Technology, KSU, Riyadh.

First Report on Ambisome-Associated Allergic Reaction in Two Sudanese Leishmaniasis Patients

Post kala-azar dermal leishmaniasis (PKDL) and mucosal leishmaniasis (ML) are serious clinical forms of leishmaniasis caused by Leishmania donovani parasites in Sudan. Although pentavalent antimonys are used as the first line of treatment of all clinical forms of leishmaniasis, persistent PKDL and ML patients are treated with liposomal amphotericin B (Ambisome) as a second-line drug. In this work, we report the development of allergic reactions by a PKDL and a ML Sudanese patient to Ambisome. The findings warrant future close supervision of patients to be treated with the drug.

THYROID DYSFUNCTION

Objectives: Studies on relation between serum lipids and thyroid dysfunction are numerous but, on the whole, desultory and inconclusive. The aim of this study was to investigate the concentration of serum triglyceride, cholesterol and cholesterol profile in Sudanese patient with thyroid dysfunction. Design: A case control study. Period: April 2008 to June 2009. Setting: Khartoum, Omdurman and Ibrahim Malik teaching Hospital, Khartoum State. Material and Methods: 200 Sudanese patients with thyroid dysfunction (hypothyroidism 100, hyperthyroidism 100) was compared with 100 healthy subjects as control group . Serum samples was taken and cholesterol, triglyceride, LDL and HDL levels were analyzed using colorimetric methods. Results: The mean ±SD serum triglyceride, total cholesterol, HDL and LDL in normal case respectively were 63.3±8.5, 163±6, mg/dl 44.3±3.7 mg/dl, 78.8±8 mg/dl. Among hypothyroidism, the mean ±SD serum total cholesterol, LDL, HDL respectively were 213.9±31.8 mg/dl, 38.5±3.5 mg/dl, 123.8±27.4 mg/dl and also among hyperthyroidism the mean ±SD serum triglyceride, total cholesterol, HDL and LDL respectively were 55.2±6.1mg/dl,152±11.5 mg/dl, 40.7±1.3 mg/dl and 76.1±9.7 mg/dl. Serum level of triglyceride, total cholesterol, and LDL is significantly elevated in hypothyroidism patients when compared with their control group (P&lt;0.05). these changes in lipids profile among hypothyrodism patients are reversed upon thyroxine (T4) replacement therapy(p &lt; 0.05). Conclusions: This study conclude that, the hypothyroidism causes significant increases of serum triglyceride, total Cholestrol, and LDL, with slight decreases in HDL level. In contrast thyroid replacement therapy reversed these changes.

Adult Disseminated Cutaneous Langerhans Cell Histocytosis with nail involvement in a Sudanese patient: A case report and review

Disseminated cutaneous langerhans cell histocytosis (LCH), are group ofrare histiocytic syndromes and idiopathic disorders characterized by theproliferation of specialized bone marrow–derived Langerhans cells (LCs)and mature eosinophils. We report a case of langerhans cell histocytosis withlimited skin and nail involvement occurred in a 26 years old male patient. Thedescribe case is an undiagnosed and relapsing case of skin and nail limited LCH, presented with erythematous greasy scales in the scalp and discrete, yellow brownish, scaly papules with areas of purpura mainly in face and trunk for 3 years duration, and then remains stable over time. The case is diagnosed and confirmed histopathologically, considered to be the first disseminated langerhans cell histocytosis in an adult to be reported in Sudan.

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.

First report on Leishmania major/HIV coinfection in a Sudanese patient

This case report emerged from a large study on biotechnological typing of leishmania parasites in Sudan. Thetyp -ing study was approved by the National Ethical Committeeof the Federal Min-istry of Health, Sudan. The approved protocol included obtaining consent of the participants for sample collection and HIV testing for unusual and severe clinical presentations to assist effective treatment and control. Thepatient in this case report gave writtenconsent for HIV testing and enrolment in the typing study. Based on the severity of the presenting lesions he was suspected of HIV coinfection and was referred to the national HIV control programme for pre-counselling and HIV testing. Following the diagnosis of

Mucosal Leishmaniasis in a Sudanese Patient

Mucosal leishmaniasis (ML) is an oral disease caused by the parasite Leishmania donovani. The disease has been proven to be pandemic in many areas of the world. It affects young men living in leishmaniasis-endemic areas. ML might be accompanied or proceeded by visceral leishmaniasis (VL), although in most of the cases seen in Sudan, ML occurs as a primary lesion. ML can mimic oral cancer or fungal infections, with ulceration as the most common finding in ML lesions. In this report, the patient came from an area known to be endemic for VL. Although the lesions were not ulcerative, the patient history was indicative for ML. Early detection and proper diagnosis were of great help in the cure and prognosis of the disease.

Rhinofacial Conidiobolus coronatus Infection Presenting with Nasal Enlargement

Rhinofacial Conidiobolus coronatus infection is a rare form of zygomycosis in humans living in the northern hemispheres. Most human cases are observed in the periequatorial areas of Africa, Asia, or South America. Only limited information regarding optimal treatment is available. We report a case of rhinofacial C. coronatus infection in an emigrated Sudanese patient. The infection was successfully treated with terbinafin and itraconazole for 12 months. Diagnosis was confirmed by microbiological culture from a tissue biopsy. Antimicrobial susceptibility testing of this organism was not predictive of optimal therapy.