النشر العلمي

  • Diagnostic and prognostic value of thrombocytopenia severity in Sudanese children with Falciparum malaria

Malaria remains one of the most significant global public health challenges, with more than 200 million clinical cases worldwide each year. Falciparum malaria accounting for up to 87.6 % of malaria cases in Sudan. Platelets abnormalities as thrombocytopenia especially severe thrombocytopenia have been associated with mortality in patients with P. falciparum infection. The aim of this study was to study the relationships between thrombocytopenia and their severity with falciparum malaria severity, parasitemia and parasite count. This study was case-control hospital based study conducted among 200 Sudanese children admitted to Wad Medani Pediatric Hospital, Wad Medani, Sudan during period September to December 2018. The study population was divided into two groups. Group 1 (UM) was 100 children with uncomplicated falciparum malaria. Group 2 (SM) was 100 children with severe falciparum malaria were diagnosed by WHO criteria. A 2.5 ml venous blood sample was collected from each children. The malaria parasitemia was determined from thick blood films using plus system. The parasite count (% of parasitized red cells counting) was counted from thin blood film. Platelets count was determined using the Sysmex XP 300 N automated hematology analyzer (Sysmex, Kobe, Japan) and confirmed and assessed using stained thin blood film. The data were analyzed using SPSS software (V 20.0) and Stat disk software (V 13.0). The mean age and male: female ratio of Group 1 (UM) were 8.83 ± 4.20 years and 1:1.22 respectively and for Group 2 (SM) were 8.63 ± 3.40 years and 1.56:1 respectively. Group 2 (61 %) associated with thrombocytopenia (mean PLTs 160.91 ± 186.24 × 109/) more than Group 1 (25 %) (mean PLTs 221.10 ± 98.69 × 109/L) (P value = 0.000). The mild, moderate and severe thrombocytopenia account for 19 %, 5 % and 1 % respectively among Group 1; and 22 %, 28 % and 11 % respectively among Group 2 (P value 0.003). Malaria thrombocytopenia was significantly associated (P value = 0.000) and negatively correlated (P value = 0.000; r = - 0.341) with malaria parasitemia. The mean parasite count in malaria thrombocytopenia (0.77 ± 0.51 %) was higher than malaria without thrombocytopenia (0.53 ± 0.36 %) (P value 0.000). Thrombocytopenia severity was significantly positive correlated with malaria parasitemia (r = 258; P value = 0.017) and parasite count (r = 0.229; P value = 0.034). The study concluded that the severe thrombocytopenia associated commonly with severe falciparum malaria and falciparum malaria hyperparasitemia.

published in World Journal of Advanced Research and Reviews

  • Impact Of Sever Plasmodium Falciparum Infection On Platelets Parameters Among Sudanese Children Living In Al-Jazira State

Background: Falciparum malaria remains one of the most global infection among children particularly in communities with poor resources. Falciparum malaria associated with several hematological changes that affect the major blood cell lines such as platelets lead to platelets parameters (platelets count and indices) abnormalities. Objectives: The aim of this study was to evaluate the effects of falciparum malaria on platelets parameters (platelets count and indices) among Sudanese children. In addition to study relationships and correlation between platelets parameters and malaria parasitemia and parasite count. Methods: A case control study was conducted in Wad Medani Pediatric Hospital. Among 100 children with severe falciparum malaria (mean age 8.63 ± 3.40 years; 61% males), 100 children with uncomplicated falciparum malaria (mean age 8.83 ± 4.20 years; 45% males) and 100 children with normal healthy children controls (mean age 10.08 ± 3.58 years; 50% males). Parasitemia and parasite count (%) was determined directly from thick and thin blood films respectively. The platelets parameters (platelets count and indices) measured by using Sysmex XP 300 N automated analyzer, and platelets count was confirmed and assessed using stained thin blood film. SPSS software (V 20.0) and Stat disk software (V 13.0) were used for data analysis. Results: 72 % of severe falciparum malaria (SM) have hyperparasitemia, while 18 % among uncomplicated falciparum malaria (UM). The thrombocytopenia account for 43 % (SM: 30.5 %; UM: 12.5 %), low PCT account for 35.5 % (SM: 27 %; UM: 8.5 %) and high PDW account for 46.5 % (SM: 23.5 %; UM: 23 %) in falciparum malaria cases. The mean PLTs count and PDW were statistically significantly differences between falciparum malaria cases and normal healthy control (P value 0.000 and 0.008 respectively). The mean PLTs count and PCT in severe falciparum malaria cases were lower than uncomplicated falciparum malaria cases (P value 0.005 and 0.000 respectively). The PLTs count and PCT had significant negative correlation within malaria parasitemia (P value 0.000; r -0.286; P value 0.004; r -0.205 respectively) and malaria parasite count (P value 0.000; r -0.450; P value 0.000; r -0.270 respectively). Conclusion: The study concluded that thrombocytopenia, low PCT and high PDW were observed as most platelets parameters changes in falciparum malaria. PLTs count along with PCT to be recommended as hematological diagnostic markers and prognostic tool to assess the disease severity and to improve the management of falciparum malaria among patients.

published in Int. j. clin. biomed. res.

  • Assessment and evaluation of Neutrophils: Lymphocytes Ratio among Children with Falciparum Malaria in a Sudanese Endemic Area

Background: Severe Falciparum malaria causes high mortality and morbidity among children, especially in tropical regions. Neutrophils to lymphocytes ratio (NLR) is a prognostic indicator of inflammatory diseases, cancers, cardiovascular events, and many types of infectious diseases - including parasitic ones, e.g., Falciparum malaria.
Objectives: We aimed to evaluate NLR among Sudanese children, infected with Falciparum malaria, attending Wad Medani Pediatric Hospital, Gezira State, Sudan, to assess its relationship to the intensity of parasitemia and disease severity.
Methodology: This case-control study included 300 Sudanese children. They were composed of 100 severe Falciparum malaria (aging 8.63 ± 3.40 years; 39% female), 100 uncomplicated Falciparum malaria (aging 8.83 ± 4.20 years; 55% female) and 100 normal age-matching healthy controls (aging 10.08 ± 3.58 years; 50% female). Total and differential white blood cell counts were measured using by Sysmex XP300N Autoanalyzer, and NLR was calculated (absolute neutrophils count/absolute lymphocytes count). The data were analyzed using SPSS software (V 20.0) and Statdisk software (V 13.0).
Results: Leukocytosis (34%) and increased NLR (30%) were observed in Falciparum malaria cases. The mean of NLR in Falciparum malaria patients was significantly higher than controls (3.47 ± 3.51 and 2.87 ± 3.01, respectively; p ˂0.001). However, NLR did not show significant difference comparing patients stratified for disease severity (severe vs. mild malaria; p = 0.735). Severe Falciparum malaria and absolute neutropenia were significantly correlated (p = 0.006 and r = 0.194; OR = 3.17).
Conclusion: The study concluded that leukocytosis, increased NLR, absolute neutropenia and absolute lymphocytopenia were most common WBCs changes observed in Falciparum malaria. Significant association was observed between development of severe falciparum malaria and absolute neutropenia. To improve management of severe malaria, absolute neutrophil count may be recommended, along with others parameters, as predictive indicator for the disease severity.

published in Jouf University Medical Journal

  • Assessment of Serological Tests for Diagnosis of H. pylori Infection among Dyspeptic Patients, Gezira State, Sudan

Background: H. pylori is one of the most common damaging human pathogen, it identifies as
common agent of gastroenteritis infections causes more hard GIT symptoms and potential complications like
stomach cancer. Prevalence of H. pylori in Africa was reported about 79.1%, most likely due to
socioeconomic factors. Several techniques have been developed to give the more reliable results for patient’s
administration and to insure that the organism was eliminated flowing treatment.
Objectives: Many laboratories in Gezira State, Sudan using serological tests to screen and diagnosis the H.
pylori through antigen and anti H. pylori antibodies. There for this study was conducted in adult dyspeptic
patients to evaluate ELISA and ICT in diagnosis of symptomatic H. pylori infections and comparing with
PCR for detection of 16s rRNA gene.
Method: Descriptive cross-sectional study was conducted on selected 102 adult dyspeptic patients their age
ranged between (20 – 70 years) attending Gezira Center for G.I.T Endoscopy and Laparoscopic Surgery
during 2016 – 2019. Stool, venous blood and Antrum biopsy samples were collected from each participants.
ICT was used to screen the stool antigen and serum IgG antibody. ELISA technique was performed to
investigate serum IgG and IgA. 16s rRNA gene was detected in antrum biopsy sample using PCR. The data of
study group was collected by constructed questionnaire and analyzed by SPSS program ( V. 20).
Results: Epigastric pain (74.0%) was most common clinical finding among patients. According to the PCR
method out of 102 samples 53 (51.9%) were positive for H. pylori and 49 (48.1%) were negative. 31 (30.4%)
of patients were positive IgA by ELISA with sensitivity (66.8%), specificity (75.0%) and AUC (0.551). In
contrast 71 (69.3%) patients were positive IgG by ELISA with sensitivity (69.8%), specificity (31.2%), and
AUC (0.505). Furthermore 60 (58.8%) patients were positive ICT for serum IgG with sensitivity (45.3%),
specificity (62.5%), and AUC (0.539). While 48 (62.34%) patients were positive ICT for stool Ag with
sensitivity (79.2%), specificity (58%.6) and AUC (0.689).
Conclusion: Serological tests are simple, fast and easy technique but had many limitations for screening of
H. pylori infection so the serological tests for diagnosis of H. pylori should be confirmed with other more
diagnostic tests.

published in International Journal of Academic Health and Medical Research (IJAHMR)

  • Assessment of Cytological Atypia, AgNOR Count and p53 Protein in Epithelial Oral Mucosa Exposed to Toombak Among Sudanese Snuffers

Background: Toombak is known to be contain a high concentration of tobacco specific nitrose amine (TSNA), which is a
potent carcinogen. Therefore, the high frequency of patients affected with oral cancer, who were mostly toombak dippers reflect the
importance of the subject. In recent two decades, there are dramatic switch from histopathological to cytological and molecular
methods of disease diagnosis and evaluation, and have gained importance as rapid and simple methods. Objective: The study aimed
to assess the cytological atypia, argentaffin nucleolar organizer reason (AgNOR) and p53 protein in epithelial oral mucosa exposed
to Toombak among Sudanese users. Methods: Descriptive prospective cross-control study was conducted on 100 individuals of
toombak users. Oral mucosal smear samples were prepared and stained by PAP stain, AgNOR stain and immunocytochemistry
(ICC) application use p53 as primary antibody. Results: The age of participants was ranged between 18 – 75 years with the mean
of 40.94 years. Epithelial atypia was observed in 6% (6/100) of examined smears by PAP stain while the AgNOR increased in
number with 31% (31/100). Furthermore, the p53 protein was positive in 3% (3/100) of participants. The controlled group showed
no cellular changes. AgNOR had significant correlation within age (P value = 0.000), Toombak chewing duration /year (P value =
0.000), and Toombak chewing frequency /day. Also there was an association between cellular changes and position of Toombak
dipper, mainly increased in lower lip. Conclusion: Oral exfoliative cytology is a reliable, simple non – invasive procedure that can
be implemented for comprehensive oral screening program. AgNOR was more sensitive for detection of cytological changes.

published in International Journal of Academic Health and Medical Research (IJAHMR)

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