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    Prevalence of Visceral Leishmaniasis among Wildlife Rangers in Eldinder locality- Sinnar State , Sudan 2021
    (University of Khartoum, 2022-03-14) Bashir Ibrahim Abdalrahman Ahmed
    Background: Visceral leishmaniasis , also known as kala-azar is fatal if left untreated in over 95% of cases , according to the World Health Organization estimates, about 500,000 new cases of Visceral leishmaniasis occur every year globally. 90% of which is borne by 6 countries: India, Bangladesh, Sudan, South Sudan, Brazil and Ethiopia ,Visceral Leishmaniasis is a parasitic disease caused by a group of leishmania parasite species, and transmitted by several species of sandfly. It has been reported in Sudan since the beginning of the twentieth century, mainly in the eastern part of the country. Recent epidemics have claimed thousands of lives in the Sudan, The objective is to study the prevalence of visceral Leishmaniasis among Rangers for wildlife. Methods: This descriptive cross-sectional community based study was conducted among Wildlife Rangers in El dinder locality- Sinnar State ,Sudan 2021, the study covered all the rangers for Wildlife to obtain a sample size of 500 rangers, data was collected using a pre- prepared and pretested questionnaire and then directed to the Wildlife rangers to collect data regarding their demographic characteristic and Visceral Leishmaniasis differed aspects ,and also an interview with Director of Department of Primary Health Care in El dinder Locality to collect data regarding Visceral Leishmaniasis among Wildlife rangers, and also reviewing Rangers records to estimate the prevalence of Visceral Leishmaniasis among Wildlife rangers, data was analyzed using Statistical Package for Social Science version 21 and the associations between different variables were checked using X2_ test , P-value ≤0.05 was considered significant . Results: The study showed that the prevalence of Visceral Leishmaniasis among Wildlife Rangers was (27.4%), (68%) of the infected rangers were in age group between 20 to 30 years old , (93%) of the rangers were males , (83.8% ) of the infected were Soldiers (16.2%) were Officer ,the Soldiers knew visceral leishmaniasis ,causative agent, control the transmission and mode of transmission of visceral leishmaniasis with (78%) ,)75%) , (80.7%)and (74.8%) respectively , and 43.2%of the Wildlife rangers Sleeping under bed net. the study showed statistical association between prevalence of Visceral Leishmaniasis among rangers from one hand and their educational level, military rank , knowledge about Leishmaniasis, sleeping under bed nets, knowledge about control the transmission from another hand with P.value= 0.001, 0.004, 0.000, 0.001, 0.012 respectively, also the study showed no statistical association between Visceral Leishmaniasis and family income/month (P.value=0.352). from the an interview the Wildlife Soldiers are located in forestes areas where the vector of leishmania disease is present, so they are more susceptible to infection than others. Conclusion: The study concluded that the prevalence of Visceral Leishmaniasis was very high among Wildlife Rangers, and associated with many factors as educational level , military ranking sleeping under bed nets, knowledge about control transmission. so based on the findings the study recommended that the infected rangers is so essential should be treated, prevention of visceral Lieshmenasis transmission through the following actions sleeping under bed nets, Using repellents, effective vector control program directed to the sand flies is important, providing adequate number of bed nets for the rangers also control of sand flies is of great an importance , and using sand fly repellents in form ofcreams and oils continuously, and also health education program directed to the Soldiers to induce positive change their knowledge , attitude and practices towards Visceral Leishmaniasis different aspects . المستخلص الخلفية :الليشمانيا الاحشائي المعروف باسم الكلازار قاتل اذا لم يعالج صاحبه وهناك اكثر من 95% من الحالات علي مستوي العالم , ووفقا لتقديرات منظمة الصحة العالمية تحدث حوالي 500000 حالة جديدة منه كل عام علي مستوي العالم , 90% منها تحدث في ستة دول : الهند,بنغلاديش , السودان,جنوب السودان ,البرازيل واثيوبيا . الليشمانيا الاحشائي هو مرض طفيلي تسببة مجموعة من انواع طفيل الليشمانيا وينتقل بواسطة عدة انواع من الذباب الرملي , وقد سجل المرض في السودان في بداية القرن العشرين وبصورة رئيسة في الجزء الشرقي من البلاد وقد أدت الاوبئة في الاونة الاخيره الي الكثير من حالات الوفيات, الهدف الرئيسي لهذه الدراسة هو دراسة معدل انتشار مرض الليشمانيا الاحشائي وسط عساكر الحياة البرية بمحلية الدندر ولاية سنار. مواد وطرق البحث:أجريت هذه الدراسة الوصفية المقطعية وسط عساكر الحياة البرية بمحلية الدندر ولاية سنار – السودان 2021م , غطت هذه الدراسة جميع عساكر الحياة البرية بالمحلية والبالغ عددهم (500) عسكري وتم جمع البيانات بواسة استبيان معد مسبقا يحتوي علي المعلومات الديموغرافية وجه للعساكر وإجراء مقابلة مع مدير قسم الرعاية الصحية الاولية بمحلية الدندر حول إنتشار المرض بالمنطقة وتم مراجعة سجلات العساكر الطبيه لتحديد معدل إنتشار مرض الليشمانيا الاحشائي وسط عساكر الحياة البرية بمحلية الدندر ولاية سنار وتم تحليل البيانات باستخدام برنامج الحزمه الاحصائية اصدار 25 وتم اجراء اختبار الفروقات بين المتغيرات باستخدام اختبار مربع كاي اسكوير بمعدل ثقة 95%. النتائج: أظهرت الدراسة ان معدل انتشار الليشمانيا الاحشائي وسط عساكر الحياة البرية بمحلية الدندر هي 27.4% وكشفت الدراسة ان اعلي نسبة اصابة كانت في الفئة العمرية من 20 الي 30 حيث بلغت نسبة الاصابة 68% واوضحت الدراسة ايضا ان معظم الاصابات كانت بين الذكور حيث بلغت 93% وايضا اظهرت ان نسبة الاصابة اعلي في الجنود مقارنة بالضباط حيث بلغت نسبة الاصابة 83.8% , واظهرت الدراسة ان العساكر يعرفون مرض الليشمانيا الحشوي , العامل المسبب, طرق السيطرة علي المرض وطرق انتقال المرض وذلك بنسب (78%), (75%), (80.7%) و(74.8%) علي التوالي ، وأن 43.2% يستخدمون الناموسيات المشبعة للوقاية من إنتقال المرض. واثبت الدراسة ان هنالك علاقة احصائية قوية بين الاصابة بالمرض زسط عساكر الحياة البرية و المستوي التعليمي ,الرتبة العسكرية .معرفة المرض والنوم تحت الناموسية حيث وجد ان القيمة الاحتماليه تساوي 0.001, 0.004, 0.000و0.0012 علي التوالي, واظهرت الدراسة ايضا انه لاتوجد علاقة احصائية بين الاصابة بالمرض وسط العساكر ومعدل الدخل الشهري وذلك بقيمة احتمالية 0.342. مدير الرعاية الصحية الأولية المخاوف يقع جنود الحياة البرية في المناطق الغابات حيث يوجد ناقل مرض الليشمانيا ، لذلك هم أكثر عرضة للعدوى من غيرهم. الخلاصة:كشفت هذه الدراسة ان الليشمانيا الاحشائية تمثل مشكلة صحية رئيسية وسط عساكر الحياة البرية وان معدل الانتشارعالي وسط العساكر وارتباطها بعوامل كثيره منها مستوي التعليم , الرتبة العسكرية , النوم تحت الناموسيات ومعرفة طرق مكافحة الناقل ,واوصت الدراسة بضرورة معالجة العساكر المصابين والقيام باجراءات وقائية تجاه غير المصابين مثل الرش بالمبيد ذو الاثر المتبقي للقضاء علي الناقل والنوم تحت الناموسات والتثقيف الصحي للعساكر من خلال حملات اعلامية كبيره لرفع مستوي وعيهم بخطورة المرض وكيفية اكتشافة مبكرا وطرق الوقاية منه وعلاجه.
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    Analysis of Humoral Immune Response of Pulmonary Tuberculosis Patients to Cloned mycobacterium tuberculosis Antigens
    (University of Khartoum, 2013) Shimaa Awad Abdelbagi Haj Ahmed
    Abstract Background: Diagnosis of tuberculosis (TB) remains problematic despite many new advanced diagnostic methods. A reliable and rapid diagnostic test, which could be performed in any standard pathology laboratory, would help to obtain definitive early diagnoses of TB. Objects: To evaluate the diagnostic activity of seven cloned antigens; IDRI- Ag 1 (196-134), IDRI-Ag2 (030306), IDRI-Ag3, IDRI-Ag4, IDRI-Ag5, DID90B and DID90B for pulmonary tuberculosis. Methods:A cross-sectional, laboratory-based study was conducted in Khartoum state. The participants were consented to participate in the study. Sputum and serum samples were collected from ninety eight pulmonary tuberculosis patients and ten negative controls. The epidemiological and clinical data were collected form all participants. To confirm TB diagnosis; Sputa were microscopically examined using Ziehl Neelsen staining and Auramine O staining techniques then cultured according to modified Pettrof’s method. The mycobacteria isolates were subjected to molecular identification using the Line Probe Assay technique. The diagnostic activity of seven Mycobacterium TB cloned antigens for pulmonary TB was determined using indirect ELISA. The data was analysed using SPSS version 16. Results: Of the one hundred and eight enrolled participants, direct ZN stain and Auramine O staining identified 71.4% positive whereas 28.6% were negative. The Culture results from samples identified 52% culture positive, 40.8% culture negative and 7.1% were contaminated. The molecular result by Line Probe Assay to the same samples identified 42% as typical Mycobacterium tuberculosis complex and 3% was a typical mycobacteria species, 49% non TB and 6% no DNA found. Five antigens IDRI-Ag 1, IDRI-Ag2, IDRI-Ag4, IDRI-Ag5, and DID90B were significantly reactive with patients’ sera (P value were 0.04, 0.016, 0.007, 0.024 and 0.004, respectively) Significance was (p<0.05). Conclusion: Five MTB cloned antigens (IDRI-Ag 1, IDRI-Ag2, IDRI-Ag4, IDRI-Ag5, and DID90B( were significantly reactive (p<0.05) with sera collected from confirmed pulmonary TB patient; could be considered as promising diagnostic markers of pulmonary tuberculosis. المستخلص خلفية:- تشخيص الدرن لا يزال إشكالية على الرغم تعدد الأساليب التشخيصية المتقدمة الجديدة. ومن شأن إختبار تشخيصي موثوق وسريع، والذي يمكن اداؤه في أي مختبر لعلم الأمراض القياسية، سيساعد للحصول على تشخيص نهائي مبكر لمرض الدرن. كان الهدف من هذه الدراسة تتقييم التشخيص لسبعة من مولدات المضادات المستنسخة . IDRI - G 1 (196-134) ، IDRI - AG2 (030306)، IDRI - AG3 ، IDRI - AG4 ، IDRI - AG5 ، DID90B و DID90B لمرض السل الرئوي. المنهجية البحثية:- وقد أجريت الدراسة بناء دراسة معملية مقطعية عرضية ، في ولاية الخرطوم . وقد وافق المشاركون على المشاركة في الدراسة . تم جمع عينات من البلغم و الامصال من ثمانية وتسعين من مرضى السل الرئوي وعشرة ضوابط سلبية . وقد تم جمع البيانات الوبائية والسريرية من كافة المشاركين . لتأكيد تشخيص السل ، تم فحص البلغم مجهرياَ باستخدام صبغة زلينليسون والاورمين ثم تمت زراعتها وفقاً لطريقة بيتروف المتطورة . وخضعت المعزولات لاختبارات التحديد الجزيئي بإستخدام تقنية (ال بي اى). تم تحديد النشاط التشخيصي بتقييم سبعة من مولدات المضادات المتفطرة للدرن المستنسخة لتشخيص الدرن الرئوي بإستخدام إختبار الامتصاص المناعي المرتبط بالخميرة (غير المباشر). تم تحليل البيانات باستخدام النسخة SPSS (إصدارة 16) النتائج:- من بين المشتبه بهم المسجلين، هنالك 71.4٪ إيجابي البلغم في حين أن 28.6٪ كان سلبي البلغم وذلك عن طريق الفحص المجهري. وكانت نتائج التزريع للعينات كالتي: 52 ٪ كانت ايجابيه النمو و42.8% كانت سالبة النمو، 7.1 ٪ كانت ملوثة . وكانت نتيجة الفحص الجزيئي لنفس العينات بإستخدام تقنية (ال بي اى) 42 ٪ هي من نوع المتفطرة الدرنية و3 ٪ من نوع المتفطرات غير الدرينة، 49 ٪ غير السل و 6 ٪ لم يتم العثور على الحمض النووي . وتم إختبار الامتصاص المناعي المرتبط بالخميرة (غير المباشر) لتقييم اللمستضدات السبعة المستنسخة من المتفطرة الدرينية التي قدمها معهد بحوث أمراض المتوطنة- جامعة سياتل USA وهي: (IDERI)؛ IDRI-AG 1 (196-134)، IDRI-AG2 (030306)، IDRI-AG3، IDRI-AG4، IDRI-AG5، DID90B وDID90B مع أمصال المشتبه بهم. وكانت هنالك خمسة من مولدات المضادات ذات فعل ايجابي كبير وهم:IDRI-AG 1، IDRI-AG2، IDRI-AG4، IDRI-AG5، DID90B والقيم المحتملة كانت 0.04، 0.016، 0.007، 0.024 و 0.004 على التوالي. (القيمة المعيارية اقل من 0.05). الخلاصة:- خمسة من مولدات المضادات المستنسخة IDRI-AG 1، IDRI-AG2، IDRI-AG4، IDRI-AG5، DID90B التي ثبت تفاعلها الايجابي مع أمصال مرضي الدرن (القيمة المعيارية اقل من 0.05)، والتي يمكن اعتبارها أداة تشخيص واعدة لمرض الدرن الرئوي.
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    Assessment of Coppicing Vigor (Cutting Tools, Tree Diameter and Cutting Heights) of Acacia seyal Del. Var. seyal in Nowara Reserve Forest, Sinnar State, Sudan
    (University of Khartoum, 2012) Elzihor Mohamed Adam Eteem
    This study assessed coppicing vigor affected by cutting tools (axe and chainsaw), cutting heights (stump height) and trees diameters (age) of Acacia seyal var seyal in Nowara natural reserve forest in Sinnar State during May 2018 and February 2020. The experimental design used was a completely randomized design. 108 trees of Acacia seyal var seyal were randomly selected in a forest stand area of 5 ha; 54 trees were felled with an axe and chainsaw for each; 18 trees were felled within each of the three diameter classes of 7.0 – 10.9 cm, 11.0 – 14.9 cm and 15.0 – 18.9 cm. The trees per diameter classes were cut at three stump height levels, 10 cm, 20 cm and 40 cm, 6 trees for each stump height. The soil profile was demarcated, dug, described and sampled; soil samples were air dried, crushed and passed through a 2 mm mesh sieve and were analyzed for their physicochemical properties (particle size distribution, bulk density, calcium carbonate, PH, Ec, Ca, Mg, Na and K, organic carbon, nitrogen and phosphorus). Number of sprout shoots per stumps was recorded, together with numbers of leader sprouts, and their diameters and heights. The results revealed that the soil profile in Nowara forest was characterized by high silt and clay contents, with texture class silt clay. The PH was alkaline, and the soil was carbonated, it was not compact, non saline and non sodic and it is normal soil for growth of A.seyal trees. The results of Acacia seyal sprouts revealed that, to get maximum number of coppices and best number of leader, diameter and height of leader coppice the trees should be cut when young with the small diameter classes (7.0-10.9 cm) - (11.0-14.9 cm). Cutting by chainsaw indicated more significant effects on numbers of sprouts, numbers of leader sprouts, diameter and height of leader sprouts than the axe cutting. The study recommends falling A. seyal trees when young (Diameter classes of 7.0-10.9 and 11.0-14.9 cm), cut heights from10-20 cm. Protect of the A. seyal felling site from the animal damage is indispensable for the success of regeneration by coppicing system. Coppice system can play important role in silviculture of Acacia seyal in Sudan if coppice shoots are properly managed to meet the purpose of production. Factors other than stem diameters, cutting heights and cutting tools might have effects on coppicing of Acacia seyal and need to be studied in depth in the future.
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    Predisposing Immunogenetic Factors To Type I Diabetes Mellitus Among Saudis In Riyadh Area, Saudi Arabia
    (University of Khartoum, 2018) Nezar Abdullah Eltayeb Elsheikh
    Background: Type 1 diabetes (T1D) is an autoimmune cell-mediated disorder characterized by destruction of insulin-producing beta cells in the pancreas leading to insulin deficiency and serious complications if untreated. Studies implicated a crucial role of genetic factors coupled with environmental triggers in T1D etiopathology. The aim of this study was to investigate the association of HLA class I (HLA-A, HLA-B, and HLA-C), HLA class II (HLA-DRB1, HLA-DQA1, and HLA-DQB1), PTPN-22, CTLA-4, and IL-2RA with T1D in Saudi Children. Materials and Methods: Two hundred and seventy-nine Saudi T1D patients and 424 healthy controls were enrolled in this study. This was a case-control study carried out at King Fahad Medical City, Riyadh, Saudi Arabia between July 2012 and July 2016. Genotyping was performed using reverse sequence-specific oligonucleotide (rSSO) assay using Luminex flow method and TaqMan® assay using real-time polymerase chain reaction (PCR). Allele, haplotype, and genotype frequencies for T1D cases and controls were calculated by direct counting using iterative expectation maximization (EM) algorithm for unknown gametic phase featured by Arlequin software package version 3.5. T1D risk assessment was determined by p-values, Odds ratios (OR) maximum likelihood, and 95% confidence intervals (CI) using SAS software statistical package version 9.3. P-value < 0.05 was set to be significant throughout the study. Results: DR3 and DR4 class II haplotypes were positively associated with T1D (P-values < 0.0001), whereas DR7, DR13, and DR15 haplotypes were negatively associated with T1D (P-values < 0.0001). HLA-A*24-B*08-C*07, HLA-A*68-B*35-C*04, and HLA-A*68-B*08-C*07 class I haplotypes conferred susceptibility to T1D (P-values ≤ 0.002), whereas HLA-A*31-B*51-C*15, and HLA-A*02-B*51-C*16 were protective (P-values ≤ 0.006). HLA-A*24-B*08-C*07-DR3 and HLA-A*68-B*08-C*07-DR3 extended haplotypes have shown positive association with T1D (P-values ≤ 0.0006) in the present study, while HLA-A*02-B*50-C*06-DR7, HLA-A*31-B*51-C*15-DR13, and HLA-A*02-B*07-C*07-DR15 were protective (P-values ≤ 0.01). DR3/DR4, DR3/DR3, and DR4/DR4 genotypes conferred susceptibility to T1D in this study (P-values < 0.0001), whereas DR7/DR13, DR7/15, DR3/DR15, and DR13/DR15 genotypes exerted protection (P-values ≤ 0.032). IL-2RA (rs3118470) C allele was susceptible to T1D in the present study, whereas T allele was protective (P-values < 0.0001). On the other hand, IL-2RA (rs3118470) CC genotype was susceptible to T1D, while TT was protective (P-values ≤ 0.0009). CTLA-4 (rs5742909) TT genotype was positively associated with T1D (P-value = 0.04), whereas CT genotype was protective (P-value = 0.007). IL-2RA (rs706778) CT genotype was susceptible to T1D (P-value = 0.006), but neither alleles nor genotypes of PTPN-22 (rs2476601) were shown any association with T1D in this study. Conclusion: HLA (class I and class II), IL-2RA (rs3118470) and CTLA-4 (rs5742909) polymorphisms were associated with T1D among Saudis. No association between PTPN-22 (rs2476601) and T1D could be shown.
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    Genetic polymorphism and other risk factors as determinants for dyslipidemia among females
    (University of Khartoum, ) Abdelbasit, Nazik Eltayeb Mohamed ; Maowia M. Mukhtar
    Background: There were formidable associations between host genes, life style (diet, obesity and physical activity) and hyperlipidemia. It has been postulated that low density lipoprotein receptor (LDLR), cholesterol ester transfer protein (CETP) and Apo lipoprotein B (ApoB) genes polymorphism could be influencing development of metabolic syndrome in women with hypercholesterolemia. Objectives: This study aimed to identify genetic mutations in low density lipoprotein receptor (LDLR), cholesterol ester transfer protein (CETP) and Apo lipoprotein B (ApoB) genes among Saudi females with metabolic syndrome and dyslipidemia. . Methods: A case control study was conducted. One hundred fifty six (156) females of 104 cases and 52 age matched controls. Cases were obese, diabetics and hypertensive (i. e. with MS), while controls were of normal weight, normal lipid profile, normoglycemic without menstrual irregularities. Anthropometric data included body mass index and waist circumference were collected using a questionnaire. Also fasting venous blood samples were collected from all subjects after informed consent and used for biochemical (blood glucose, lipid profile, leptin and total testosterone). For mutation analysis blood samples were collected for DNA extraction. Specific primers were designed and used for amplification of LDLR gene exon-4, CETP gene intron 1 (segment 1&2) and apoB gene (rsR3500Q, rs693 and rs1801701) mutations using conventional PCR. This was followed by DNA sequencing was done using Capillary Sanger method. Chromatogram files were cleaned and aligned by Finch TV and BioEdit Software program. Chromatograms ABI files variations were searched by Gene Screen program. Finally, Project Hope predicted the effect of the mutations on the structure and function of the protein. Results: The mean BMI and WC for cases were 41.97 (±6.004) and 107.5 centimeters (± 11.68), (p=0.0001) and that for controls were 24.67 for BMI (±2.67), and 69.94 centimeters (±7.85), (p=0.004) for waist circumference. Mean diastolic blood pressure was 86.5 mm/Hg (±1.53) among cases and 74.66 mm/Hg (±1.96) among controls, (p=0.0001). Searching for different variation nucleotides in chromatogram files identified 29 novel mutations in LDLR exon-4, five SNPs within CETP gene intron1 segment -1- and one SNP within segment -2- of CETP gene. ApoB nucleotide sequence gene rsR3500Q (c.10708G>A;p.R3500Q) resulted in no single nucleotide polymorphisms (SNPs) (substitution) within exon 26. apoB gene rs693 (c.7545C>T;p.T2515T) reveald 2 SNPs and apoB gene rs1801701 (c.10913G.A;p.R3638Q) resulted in 2 SNPs. The mean FBG was 162.5 (±6.51) among cases and 66.29 (±4.37), (p=0.0001) for controls. Lipid profile including TG, TC, LDL-C and HDL-C were 204.5 mg/dl (±11.83), 232.5 mg/dl (±10.11), 150.5 mg/dl (±13.51) and 53.2 mg/dl (±8.94) for cases and 67.86 mg/dl (±6.16), 115.9 mg/dl (±8.67), 108.2 mg/dl (±11.83) and 98.67 mg/dl (±6.74) among the control group, the differences were statistically significant (p=0.0001). The mean testosterone and leptin concentrations were found to be 2.00 ng/ml (±0.31) and 27.95 ng/ml (±3.62) within cases and 1.05ng/ml (±0.10) and 5.22 (±1.38) among controls respectively. Statistically significant (p=0.0001) variation between cases and controls were observed for these biochemical and hormonal parameters. Conclusion: This study confirmed that large number of different mutations in the LDLR gene were present among cases due to diversity regarding race and ethnic origin of Makkah population and therefore, the presence of heterogeneity of mutations in LDLR gene. Five different SNPs were detected within intron 1 of CETP. Complete absence of apoB rsR3500Q when investigated. However, the most significant finding was polymorphisms of rs693 (7545C>T) and rs1801701 (c.10913G>A; p.R3638Q) in apoB exon 26. This exon 26 SNPs were known to be associated with high levels of TGs.