Treatment of iron deficiency anaemia with the natural hematinic Carbaodeim.

Iron deficiency anaemia is frequently seen in the paediatric age group. Modifying the treatment options according to the affected area resources will help accessibility and compliance to treatment. Response of children with Iron deficiency anaemia to a natural hematinic (Carboadeim) versus iron syrup plus folic acid treatment was compared in this study. This is a prospective, interventional, controlled, hospital-based study conducted among children with iron deficiency anaemia residing in Hussein Village, Gezira State who attended Giad Hospital. Patients were randomly divided into two groups; the control received iron supplements and folic acid, and the case received a combination of carrots, baobab (Adansonia digitata) and godeim (Grewia tenax) which is known as (Carboadeim). Blood tests were taken for investigations at start of treatment, after 7-10 days, 6 weeks and 3 months. Complete blood count, reticulocyte count and serum ferritin were taken as indicators. The mean haemoglobin level initially in the cases and controls was 7.38 and 7.35 gm/dL, respectively; after three months the mean was 11.67 and 11.384 gm/dL, respectively. The mean serum ferritin in the case and control groups was found to be 10.30 and 10.87 ng/ml, respectively at the start of treatment; and after 3 months they were reported to be 44.34 and 75.7 ng/ml confirming the positive response to treatment by Carboadeim. In conclusion Carboadeim is a naturally available and cost-effective hematinic blend that might be added to the food menu as a supplement as well as a treatment of nutritional anaemia in children.

Vitamin A-rich porridge for Boarding Khalwa students with night blindness.

Khalwa is a non-governmental boarding school specialized in teaching Quran to Sudanese children. Food supply to Khalwa is completely dependent on donations. Students are fed on low cost and low nutritional value diet made of sorghum flour porridge and a stew made of dry okra, onion and oil. The incidence of night blindness among these students is reported by the Nutrition Department of the Federal Ministry of Health, Sudan, in 2005 as 0.9%. In this study we interviewed and examined 453 Khalwa students in Umbada area, however blood sampling for assay of vitamin A level was not acceptable by the Khalwa authorities. Thirty four students (7.5%) showed clinical evidence of Vitamin A Deficiency (VAD), 67.6% of them for a period of less than 6 months which was consistent with their stay in Khalwa. Vitamin A fortified sugar is used in Kenya, Zambia, South Africa and Honduras but it is costly and sugar-containing foods and drinks are not in common use by Khalwa students. To supply students with a good amount of vitamin A, we prepared a new porridge formed of sorghum flour; peeled, chopped and boiled pumpkins in addition to their traditional stew. One meal per student contained 250 grams of sorghum flour and 125 grams of pumpkin which supplies 611µg (10891 I.U.) of vitamin A according to the USDA SR-25 composition tables (>100% Daily Value). Compared to the old porridge, there was significant differences (P <0.05) in vitamin A, carbohydrate, protein, fiber, fat, ash and moisture contents. All students accepted the taste of the new porridge and 91.2% agreed that it is not difficult to prepare. We conclude that adding pumpkins to Khalwa porridge is cost effective and may help preventing VAD and its deleterious effects on vision and health.

Carbaodeim: A natural haematinic blend for treatment of dimorphic anemia of malnutrition.

Sudanese nomadic tribes living in the Sahara Region west of Khartoum State depend completely on food made of sour milk and other milk products cooked with onion and dried meat. This is usually added to a porridge made of sorghum flour. Goat and sheep milk is the main component and green vegetables are not commonly taken with this meal. Adults, who move out of their residential areas may have access to other types of food in towns and cities while mothers and children, staying always at home, do not have similar chances. Furthermore, in these dessert areas there is always difficulty in reaching health care facilities and getting medicines. Children from these areas who presented to Ombada Teaching Hospital - west of Omdurman- had very low hemoglobin and their peripheral blood picture showed dimorphic type of anemia. In the search for locally available ingredients that can prevent the occurrence of this type of anemia among the affected population, we studied the constituents of the commonly available fruits and vegetables in the area. We succeeded to formulate a blend (Carbaodeim) made of Carrots (25 gm), Baobab (100 gm) and Godeim (100 gm) which is found to contain iron (34.8 mg), folic acid (2.5 mg), ascorbic acid (372.8 mg), vitamin A (7000 mg), calcium (896.7 mg) and potassium (1910 mg), with many other components that have high nutritional value. This blend is easy to make, safe, nutritious, refreshing and cost effective. Carbaodeim is a naturally available and cost effective haematinic blend that might be added to the food menu of nomadic people as well as patients admitted to hospital with malnutrition or dimorphic type of anemia.

Dandy-Walker malformation and neurocutaneous melanosis in a three-month-old infant.

Dandy-Walker Malformation (DWM) is a rare congenital malformation of the brain. It is characterized by cystic enlargement of the fourth ventricle which is communicating with an enlarged posterior fossa, cerebellar dysgenesis, high tentorial insertion and hydrocephalus. Neurocutaneous Melanosis (NCM) is a congenital neurocutaneous syndrome characterized by large or multiple melanocytic nevi and benign or malignant melanocytic tumors of the leptomeninges. We report three months old boy who presented with projectile vomiting associated with a noticeable increase in head size. Several congenital nevi were seen all over his body with evident signs of hydrocephalus. The association of DWM and NCM is a rare complex, and to our knowledge, this is the eleventh case to be reported in the literature. In this article, we discuss the proposed pathogenesis, classification and management of the condition.