Diagnosis and management of bacterial meningitis in adult Sudanese patients: a six years hospital based, retrospective, cross-sectional study.

PURPOSE: To evaluate the diagnosis and management of bacterial meningitis in adult Sudanese patients in accordance with the Infectious Diseases Society of America (IDSA) guidelines for bacterial meningitis management. PATIENTS AND METHODS: A cross-sectional, retrospective study design was used to recruit all patients aged > 18 years who were diagnosed with or suspected of having bacterial meningitis and admitted to Wad Medani Teaching Hospital, Gezira State, Sudan, between January 2017 and October 2022. RESULTS: In total, 201 patients were included in the analysis. The mean age of the participants was 44.1 ± 21.4 years, and 107 (53.2%) were male. Community-acquired bacterial meningitis accounted for 193 (96%) of the studied patients, and only 8 (4%) of the patients had healthcare-associated meningitis. Neuroimaging was utilized appropriately in 148 (73.6%) patients, blood cultures were not performed entirely, and lumbar puncture was seldom performed in 1 (0.5%) patient. Corticosteroids were appropriately administered to 65 (32.3%) patients, and antibiotics were administered appropriately to only 5 (2.5%) patients. Ceftriaxone 185 (76.1%) was the most frequently utilized antibiotic, followed by vancomycin 23 (9.5%). In terms of overall adherence, this study demonstrated that the IDSA guidelines were not followed at all in the treatment of patients with suspected bacterial meningitis. CONCLUSION: The results of this study contradict the IDSA guidelines for the standard of care for bacterial meningitis. Antibiotic regimens are often incorrect, corticosteroids are administered appropriately in approximately one-third of patients, and neuroimaging is reasonably utilized. This study raises attention to several important issues regarding the diagnosis of bacterial meningitis, including the lack of confirming microbiological tests and the reliance of the diagnosis primarily on CT and clinical examination.

Assessment of myeloid response and iron status among Sudanese pediatric ESKD on hemodialysis through reticulocyte parameters and ß-globin mRNA expression.

BACKGROUND: Sudanese children with End-Stage Kidney Disease (ESKD) often show limited improvement in hemoglobin levels despite treatment with recombinant human erythropoietin (rHuEPO). This study aims to assess the response to rHuEPO therapy by analyzing ß-globin mRNA expression and reticulocyte parameters. Additionally, it classifies anemia among Sudanese pediatric patients based on iron status, considering age and gender as biological markers for evaluating treatment response. METHODS: A prospective observational cohort study was conducted from January 2019 to February 2020 in Khartoum, Sudan, involving 45 anemic children aged 2 to 15 years diagnosed with ESKD. The treatment protocol included rHuEPO injections and maintenance hemodialysis. Laboratory assessments consisted of complete blood count (CBC), absolute reticulocyte count, ferritin, and transferrin measurements. ß-globin mRNA expression was quantified using reverse transcription polymerase chain reaction (RT-PCR), and reticulocyte parameters, including Reticulocyte Hemoglobin Content (CHr), percentage of hypochromic reticulocytes (HYPO%), and Immature Reticulocyte Fraction (IRF), were measured via flow cytometry. RESULTS: Significant variations in hemoglobin levels were observed across different age groups (p = 0.011). Gender analysis revealed a significant association with IRF, showing a lower IRF in male patients (p = 0.017). However, there were no significant differences in hemoglobin levels between genders (p = 0.999). ß-globin mRNA expression showed considerable variability, with a strong positive correlation with hemoglobin levels (r = 0.875, p < 0.0001). CONCLUSION: Age and gender significantly influence treatment responses in children with ESKD, highlighting the need to consider growth physiology in anemia management. This study underscores the variability in ß-globin mRNA expression and its association with Flow Cytometry parameters, demonstrating their effectiveness in evaluating iron status and guiding rHuEPO dosage.

Factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia.

BACKGROUND: Health-seeking behavior (HSB) involves any action or inaction taken by individuals who perceive themselves to have a health problem or illness aimed at finding appropriate medical treatments. Studies suggest a positive relationship between the availability and quality of health services and their utilization. This study aimed to identify the factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia, to improve healthcare access and health outcomes. METHOD: A cross-sectional study was conducted targeting Sudanese residents of the Kingdom of Saudi Arabia (KSA). Participants were recruited using convenient sampling. A self-administered questionnaire was distributed electronically. A total of 494 participants were recruited for the study. RESULTS: This study showed that the majority of the participants (66.6%) visited a primary healthcare center when faced with a medical problem. However, the prevalence of self-medication in the past three months was 45.7%. Significant factors influencing health-seeking behavior included age (OR [95% CI]: 1.032 [1.000-1.066]) and lack of health insurance (OR = 1.01, 95% CI [1.00-1.02], p = 0.019). CONCLUSIONS: This study emphasizes the importance of understanding healthcare-seeking behavior among immigrant groups, particularly Sudanese immigrants in Saudi Arabia. It highlights the significance of insurance as a determinant of healthcare-seeking behavior and calls for reforming current policies to reduce disparities in accessing healthcare services.

Updates on the feasibility of utilizing e-learning to sustain medical radiation technology education in light of the escalating conflict in Sudan.

The purpose of the following paper is to offer an update on the feasibility of using e-learning to sustain medical radiation technology education in light of Sudan's ongoing crisis. The Sudanese acting Minister of Higher Education and Scientific Research issued a resolution on October 7, 2023, to reopen higher education and scientific research institutes, as well as resume all academic activities at both governmental and private higher education institutions, effective October 15, 2023. Unfortunately, due to infrastructure deficiencies and a lack of appropriate capabilities to resume face-to-face teaching of medical radiation technology in Sudan's safe states, the majority of universities, including several medical radiation technology colleges, have decided to continue the educational process via e-learning. However, Sudan's e-learning system, currently the sole means of maintaining medical radiation technology education, suffers from significant flaws. If these challenges persist, students may graduate with a limited theoretical and practical grasp. Furthermore, the implementation of this style of education deprives eligible students, particularly those living in conflict zones, of the educational opportunities they require in light of the increased threat of war continuation.

Characteristics of sudanese camel-hair fibres under subtropical desert condition.

The study assessed the quality and variability of camel hair fibres in arid regions of Egypt. Raw camel-hair samples were collected from fifteen Sudanese camels divided into seven males (414.60 ± 38.19 kg, BW) and eight females (401.67 ± 26.76 kg BW), and the study investigated the influences of animal sex on both the physical and chemical traits of camel-hair fibers. The relationships among physical properties and both mineral and amino acid content were studied. Camel's sex had no significant effect on any of the studied traits including fibre diameter (FD), prickle factor (PF), medullated fibre (MF), staple length (SL) and staple strength (SS). In the meantime, no significant differences were found between males and females in fibers' minerals contents except potassium, where fibres of females had significantly higher potassium content than those of males. For amino acids contents in camel fibres, camel sex had a significant effect only on glutamic acid, since fibres of males showed higher (P < 0.05) content than females. Fibre diameter had positive (P < 0.01) correlations with prickle factor (r = 0.83) and medullated fibres (r = 0.73). Zinc content in camel fibres was positively correlated with fibre diameter (r = 0.57; P < 0.05) and medullated fibres (r = 0.73; P < 0.01). Moreover, a significant (negative correlation coefficient P < 0.05) was found between fibre diameter and both sulfur and proline contents (r=-0.39 and - 0.56). Ammonia content in fibres was correlated negatively (P < 0.05) with prickle factor and elongation (r=-0.62 and - 0.58, respectively). The variability in the physical properties and chemical composition of Sudanese camel-hair fibers under subtropical desert conditions may shed light on the possibility of improving fiber quality.

A chromosome-scale genome sequence of sudangrass (Sorghum sudanense) highlights the genome evolution and regulation of dhurrin biosynthesis.

KEY MESSAGE: Sudangrass is more similar to US commercial sorghums than to cultivated sorghums from Africa sequence-wise and contain significantly lower dhurrin than sorghums. CYP79A1 is linked to dhurrin content in sorghum. Sudangrass [Sorghum sudanense (Piper) Stapf] is a hybrid between grain sorghum and its wild relative S. bicolor ssp. verticilliflorum and is grown as a forage crop due to its high biomass production and low dhurrin content compared to sorghum. In this study, we sequenced the sudangrass genome and showed that the assembled genome was 715.95 Mb with 35,243 protein-coding genes. Phylogenetic analysis with whole genome proteomes demonstrated that the sudangrass genome was more similar to US commercial sorghums than to its wild relatives and cultivated sorghums from Africa. We confirmed that at seedling stage, sudangrass accessions contained significantly lower dhurrin as measured by hydrocyanic acid potential (HCN-p) than cultivated sorghum accessions. Genome-wide association study identified a QTL most tightly associated with HCN-p and the linked SNPs were located in the 3' UTR of Sobic.001G012300 which encodes CYP79A1, the enzyme that catalyzes the first step of dhurrin biosynthesis. As in other grasses such as maize and rice, we also found that copia/gypsy long terminal repeat (LTR) retrotransposons were more abundant in cultivated than in wild sorghums, implying that crop domestication in the grasses was accompanied by increased copia/gypsy LTR retrotransposon insertions in the genomes.

Genomic signatures for drylands adaptation at gene-rich regions in African zebu cattle.

BACKGROUND: Indigenous Sudanese cattle are mainly indicine/zebu (humped) type. They thrive in the harshest dryland environments characterised by high temperatures, long seasonal dry periods, nutritional shortages, and vector disease challenges. Here, we sequenced 60 indigenous Sudanese cattle from six indigenous breeds and analysed the data using three genomic scan approaches to unravel cattle adaptation to the African dryland region. RESULTS: We identified a set of gene-rich selective sweep regions, detected mostly on chromosomes 5, 7 and 19, shared across African and Gir zebu. These include genes involved in immune response, body size and conformation, and heat stress response. We also identified selective sweep regions unique to Sudanese zebu. Of these, a 250 kb selective sweep on chromosome 16 spans seven genes, including PLCH2, PEX10, PRKCZ, and SKI, which are involved in alternative adaptive metabolic strategies of insulin signalling, glucose homeostasis, and fat metabolism. CONCLUSIONS: Our results suggest that environmental adaptation may involve recent and ancient selection at gene-rich regions, which might be under a common regulatory genetic control, in zebu cattle.

Mid-upper arm circumference as a substitute for body mass index in the assessment of nutritional status among adults in eastern Sudan.

BACKGROUND: Body mass index (BMI) remains the most used indicator of nutritional status despite the presence of a potentially credible alternative. Mid-upper arm circumference (MUAC) is an anthropometric measure that requires simple equipment and minimal training. The aim of this study was to compare MUAC with BMI and propose a MUAC cut-off point corresponding to a BMI of < 18.5 kg/m2 (underweight) and ≥ 30.0 kg/m2 (obesity) among Sudanese adults. METHODS: A cross-sectional study using multistage cluster sampling was conducted in New-Halfa, eastern Sudan. Participants' age and sex were recorded and their MUAC, weight and height were measured using the standard procedures. The MUAC (cm) cut-offs corresponding to < 18.5 kg/m2 and ≥ 30.0 kg/m2 were calculated and determined using receiver operating characteristic (ROC) curve analysis RESULTS: Five hundreds and fifty-two adults were enrolled in the study. The median (interquartile range, IQR) of the participants age was 31.0 (24.0 ̶ 40.0) years and 331 (60.0%) of them were females. The medians (IQR) of BMI and MUAC were 22.4 (19.1 ̶ 26.3) kg/m2 and 25.0 (23.0 ̶ 28.0) cm, respectively. There was a significant positive correlation between MUAC and BMI (r = 0.673, p < 0.001). Of the 552 enrolled participants, 104 (18.8%), 282 (51.1%), 89 (16.1%) and 77 (13.9%) were normal weight, underweight, overweight and obese, respectively. Best statistically derived MUAC cut-off corresponding to a BMI < 18.5 kg/m2 (underweight) was ≤ 25.5 cm in both males and females (Youden's Index, YI = 0.51; sensitivity = 96.0%; specificity = 54.0%), with a good predictive value (AUROCC = 0.82). Best statistically derived MUAC cut-off corresponding to a BMI ≥ 30.0 kg/m2 (obesity) was ≥ 29.5 cm in both males and females (YI = 0.62, sensitivity = 70.3%, specificity = 92.0%), with a good predictive value (AUROCC = 0.86, 95.0% CI = 0.76 - 0.95). CONCLUSION: The results suggest that the cut-offs based on MUAC can be used for community-based screening of underweight and obesity.

The role of sport in coping and resilience amongst resettled South Sudanese youth in Australia.

In this article, the use of sport as a coping strategy by South Sudanese youth who have suffered the trauma of forced migration is examined. This article explores the relationship that has emerged between the young people and sport, in particular basketball, and how they use their participation in basketball and sports to cope with the stressors of their lives. The research intended to explore to what degree sport can play in improving mental health and what mental health interventions, in general, were being sought by this marginalized demographic. This qualitative study was underpinned by the psychosocial conceptual framework. We undertook semi-structured interviews with 23 South Sudanese youth aged 14-21 years, we also conducted focus groups of 11 South Sudanese elders and parents. The results of this research were feed back to the wider South Sudanese community through two forums. The data collected were analyzed using thematic analysis. The results of the study identified sport as an important coping strategy for the participants, both as a diversion from drug and alcohol misuse, potential criminal activity and as a way to self-manage the symptoms of anxiety and depression they were experiencing, and a mechanism to enhance self-worth. The study also indicated there was a lack of mental health interventions for these young people and that they had shown a great deal of resilience to develop their own ways to deal with the trauma they had experienced. The research reported positive associations of wellbeing and participation in sport, however more research needs to be conducted to ascertain the extent to which sport impacts mental health and how this can be incorporated into interventions for Sudanese youth and young people from similar forced migration and resettlement backgrounds. This study suggested that sport can be a driving force of good for many of the young people's lives, worthy of further research.

This article examined the use of sport as a coping strategy by South Sudanese youth in Melbourne, Australia who have suffered the trauma of forced migration. The study also explored the relationship between sport in particular basketball and how the youth use participation in sport as a strategy to cope with the stressors of their lives. The research used qualitative methods of in-depth semi-structured interviews, focus groups and community forums and was underpinned by the psychosocial conceptual framework. The data collected was analysed using thematic analysis. Semi-structured interviews were undertaken with youth aged 14 to 21 years and focus groups conducted with parents and community elders. The results from interview analysis were shared with the wider South Sudanese community through two community forums. Some themes drawn from the analysis included living with trauma, mental health and culture, racial discrimination and use of sport as a coping strategy. The findings also highlighted sport as a diversion from drug and alcohol misuse, potential criminal activity and as a mechanism to enhance self-worth. The study also indicated there was a lack of culturally appropriate mental health interventions for these young people and that they display a great deal of resilience to develop their own ways to deal with the trauma they had experienced. The research recommends further research to be conducted to identify the impacts of sport on mental health and how this can be incorporated into interventions for South Sudanese youth and young people from similar forced migration backgrounds.

Knowledge and perceptions around self-management of type 2 diabetes among a Sudanese community in Australia: A qualitative study.

ISSUE ADDRESSED: People from Sudanese background are more likely to be diagnosed with type 2 diabetes (T2D) as compared to the general population. In recent years, there has been an increase in the number of migrants from Sudan to Australia. However, there is a dearth of research exploring the perceptions and experiences of self-management strategies for diabetes among this migrant Sudanese population residing in Australia. This study aims to explore these experiences and perceptions as well as to identify cultural aspects related to T2D self-management strategies for people from this migrant group. METHODS: A qualitative study using semi-structured in-depth interviews with Sudanese participants (n = 12) living with T2D was conducted in Melbourne, Australia. RESULTS: The thematic analysis found barriers to self-management of diabetes to include language differences, the burden of self-management, difficulties in accommodating traditional dietary practices in self-management, as well as the expectations of familial and social obligations. Enablers included positive relationships with health professionals, support networks, involvement in religion and adopting traditional remedies. CONCLUSIONS: This study found cultural considerations, such as incorporating traditional dietary practices and familial obligations into self-management, to be the most significant influence for this group of Sudanese participants in the way they managed their diabetes. SO WHAT: This study highlights the need for culturally appropriate provision of health services and resources for Sudanese people with T2D while recognising the value placed on traditional food choices. Importantly, the collectivist Sudanese culture must be considered for any future development and implementation of health promotion strategies.

An identical-by-descent novel splice-donor variant in PRUNE1 causes a neurodevelopmental syndrome with prominent dystonia in two consanguineous Sudanese families.

PRUNE1 is linked to a wide range of neurodevelopmental and neurodegenerative phenotypes. Multiple pathogenic missense and stop-gain PRUNE1 variants were identified in its DHH and DHHA2 phosphodiesterase domains. Conversely, a single splice alteration was previously reported. We investigated five patients from two unrelated consanguineous Sudanese families with an inherited severe neurodevelopmental disorder using whole-exome sequencing coupled with homozygosity mapping, segregation, and haplotype analysis. We identified a founder haplotype transmitting a homozygous canonical splice-donor variant (NM_021222.3:c.132+2T > C) in intron 2 of PRUNE1 segregated with the phenotype in all the patients. This splice variant possibly results in an in-frame deletion in the DHH domain or premature truncation of the protein. The phenotypes of the affected individuals showed phenotypic similarities characterized by remarkable pyramidal dysfunction and prominent extrapyramidal features (severe dystonia and bradykinesia). In conclusion, we identified a novel founder variant in PRUNE1 and corroborated abnormal splicing events as a disease mechanism in PRUNE1-related disorders. Given the phenotypes' consistency coupled with the founder effect, canonical and cryptic PRUNE1 splice-site variants should be carefully evaluated in patients presenting with prominent dystonia and pyramidal dysfunction.

Molar incisor hypomineralization, prevalence, pattern and distribution in Sudanese children.

BACKGROUND: Molar incisor hypomineralization (MIH) has serious impact on oral health-related quality of life for a child, due to its effects on tooth structure, aesthetics and behavior of the child. The current study was designed to determine the prevalence, pattern and distribution of MIH in school children in Sudan. METHODS: This was a descriptive cross-sectional study involving 568 children, aged 8-11 years from schools in Khartoum State. Following the collection of their socio-demographic data, the children were examined for hypomineralization on the 12 MIH-index teeth, the pattern and distribution of the MIH. The data collected was analyzed to obtain descriptive statistics. The results related to the socio-demography and other dental-related factors were tested using chi-square test and Spearman Rank Correlation, with the significant level set at p < 0.05. RESULTS: The prevalence of MIH in the study population was 20.1%. The majority of the participants had both permanent first molars (PFMs) and permanent incisors affected (12.5%). However, in 7.6% of the cases only molars were affected. Even though more maxillary teeth were affected when compared to the mandibular teeth, there was no statistical significant difference between the occurrence of hypomineralization on mandibular and maxillary molars (p = 0.22). Maxillary incisors were significantly more affected by MIH when related to the mandibular ones (p = 0.00). Demarcated opacities were the commonest pattern of MIH defects (69.9%) in the experimental group. CONCLUSION: The prevalence of MIH in Sudanese children was 20.1%. In both dental arches, the permanent molars and incisors were frequently affected, with the demarcated opacity type of MIH being the most common form of defect.

Evaluation of Dental Crowding and Spacing in Relation to Tooth Size and Arch Dimensions in a Sample of Sudanese Adults.

AIMS AND OBJECTIVES: This study aimed to compare tooth size and arch dimensions between normal, crowded, and spaced groups in a Sudanese sample. MATERIAL AND METHODS: A sample of 312 university students, were selected and divided into normal, crowded, and spaced groups. Each group included 104 students with equal males to females ratios. Age was ranged from 16 to 26 years. Mesiodistal (MD) tooth width of all teeth (except molars), arch perimeters, and dimension at the level of intercanine, interpremolar, and intermolar were measured for each group. ANOVA and student t-test were performed for the comparison between groups. RESULTS: The MD dimensions of all teeth are greater in crowded arches as compared to the teeth in normal dental arches, except for the width of the maxillary, left second premolar in females, and mandibular left second premolar in male. Spaced arches were presented with significantly smaller MD width in all teeth when compared to normal arches, except for the width of maxillary right second premolar, maxillary left first premolar, mandibular right and left second premolars in female, and maxillary right second premolar in male. Crowded arches exhibit the largest total tooth material followed by normal and spaced dentition. Spaced arches show the widest arch dimension and perimeters followed by normal and crowded dentitions. CONCLUSIONS: Both tooth size and arch dimensions contribute to dental crowding and spacing. CLINICAL RELEVANCE: Since the size of the teeth and dental arches affect the space availability of the dentition. These factors should be considered in the initial stages of orthodontic treatment planning to avoid compromised treatment outcomes.

Whey protein polymorphisms in Sudanese goat breeds.

The aim of the present study was to assess genetic variation that is characteristic for Sudanese goat breeds in the milk whey protein genes (LALBA and BLG). Four Sudanese goat breeds were screened for variability in LALBA and BLG genes at the DNA level by comparative sequencing of five animals per breed. Sixteen SNPs were identified in LALBA: seven in the upstream region, six synonymous, and three in the 3´-UTR. Three novel synonymous SNPs in exon 2 (ss5197800003, ss5197800012, and ss5197800004) were found in Nubian, Desert, and Nilotic, but not in Taggar goats. One SNP in the promoter of LALBA (rs642745519) modifies a predicted transcription factor binding site for Tcfe2a. The SNPs in the 3'-UTR (rs657915405, rs641559728, and rs664225585) affect predicted miRNA target sites. With respect to haplotypes in the exonic region, haplotype LALBA-A is most frequent in Nubian, Desert, and Nilotic goats, while haplotype LALBA-D is prevalent in Taggar goats. In BLG, 30 SNPs were detected: eight in the upstream gene region, two synonymous, 17 intronic, and three in the 3'-UTR. Among the 30 identified SNPs, 15 were novel. Four of these novel SNPs were located in the upstream gene region, one was synonymous, and ten were intronic. The novel synonymous SNP (ss5197800017), located in exon 2, was only found in Nubian and Nilotic goats. The SNPs ss5197800010 and rs635615192 in the promoter are located in predicted binding sites of transcription factors (M6097, Elk3, Elf5, and GABPA). Among seven haplotypes detected in the coding region, haplotype BLG-A is most frequent in Nubian and Nilotic goats while haplotype BLG-B is most frequent in Desert and Taggar goats. The high variability in regulatory gene regions among Sudanese goats could potentially affect the quality and yield of whey proteins in goat milk and provide a wide resource for genetic improvement of milk production and milk technology characteristics.

Operationalization of patients' rights in Sudan: Quantifying nurses' knowledge.

BACKGROUND: Promoting patients' rights is essential for defining the standards of clinical services within a country. Given their responsibilities, nurses can be the primary target for research to investigate the issue of patients' rights within a healthcare system. As such, assessing the knowledge of nurses about patients' rights is an essential step toward improving the quality of healthcare in limited resource settings like Sudan. OBJECTIVES: We aimed to assess the level of knowledge about patients' rights among the nursing staff at Friendship Teaching Hospital in Sudan. METHODS: This hospital-based cross-sectional study was carried out at the Friendship Teaching Hospital in Sudan. We surveyed the totality of nurses (95) at the hospital using an amended survey. The data were analyzed in SPSS software using descriptive and inferential statistics. ETHICAL CONSIDERATION: The study was approved by the Research Unit of Khartoum Ministry of Health and the Hospital administration. All respondents gave verbal consent prior to participating in the study. RESULTS: Only 48.4% of the participants knew about the existence of the Sudanese Charter of patients' rights. Nonetheless, our analysis found that 65.8% of nurses had acceptable level of knowledge (scored more than 75% of the total knowledge score) of patients' rights, and none of the participant scored less than 50% of the total knowledge score. Finally, we found no statistical association between the knowledge score and demographic data, educational level, whether the participant knows about the existence of the Charter or not and a number of other factors. CONCLUSION: Nurses' lack of knowledge about the existence of the Sudanese Charter of patients' rights adopted in 2009 rights confirms the need for further efforts by Ministry of Health to promote the document. Furthermore, further research is needed to investigate the disconnect between nurses' lack of knowledge about the existence of the charter and their awareness of the rights within the charter as well as the actual implementation of rights.

Skeletal growth, body composition, and metabolic risk among North Sudanese immigrant children.

OBJECTIVES: Children of immigrants and refugees from developing countries are at risk for poor growth that could contribute to adult chronic disease. This study describes the physical growth, bone growth, body composition, metabolic risks, physical activity, and food security of Sudanese children living in the United States. DESIGN AND SAMPLE: Cross-sectional descriptive study of 64 Sudanese children age 5-18. MEASURES: Bone mineral content (BMC), bone density (aBMD), and body composition (fat, lean mass, percent body fat) were measured using DXA. Lipids, insulin, glucose, and hs-CRP were analyzed using standardized laboratory methods. Food security was assessed with the U.S. Household Food Security Survey. Physical activity was measured through self-report questionnaire and pedometers. RESULTS: About 1/3 of children had low BMC and aBMD. Lean mass was low in 46%, and 32% were obese. Cholesterol, triglycerides, and HOMA-IR were elevated in 23.4%, 32.8%, and 15.6% of children, respectively; only 22% of children were physically active and 40% experienced food insecurity. CONCLUSION: Sudanese children may have unique risks related to low bone mass low muscle mass, high percent body fat metabolic biomarkers, inactivity, and food insecurity potentially contributing to adult osteoporosis, diabetes, and cardiovascular disease.

Validation and comparison of the Arabic versions of GOHAI and OHIP-14 in patients with and without denture experience.

BACKGROUND: The assessment of oral heath related quality of life (OHRQoL) for complete denture wearers according to a participant's subjective perception may provide an indication of the adaptive capacity of the individual. The aim of this study was to compare and assess the validation of two quality of life measures, the Oral Health Impact Profile-14 (OHIP-14) and Geriatric Oral Health Assessment Index (GOHAI), in patients with and without previous denture experience. METHODS: A total of 69 elders (36 male and 34 female; mean age, 63 years) from Dental Clinics of the University of Khartoum and the National University in Sudan, with and without previous denture experience, were included in the study. OHRQoL was assessed using two Arabic-translated questionnaires (OHIP-14 and GOHAI) before and after complete denture therapy. Global self-ratings of oral and general health were obtained, and denture satisfaction was assessed using the Denture Satisfaction questionnaire. RESULTS: Both tools had significant correlations with self-rating oral health in patients without denture experience (P < 0.05). However, no significant correlations were found in patients with denture experience. There were significant differences between pre-and post-treatment total scores with both the GOHAI and OHIP-14 (P < 0.001). Responsiveness to treatment using GOHAI and OHIP-14 revealed overall mean effect size higher in patients without (1.49) and (0.83) than those with previous denture experience (0.89) and (0.60), respectively. However, neither tool could detect significant differences between patients with and without denture experience (P > 0.05). CONCLUSION: Greater improvements of OHRQoL after complete denture therapy were observed in participants without than those with previous denture experience. The Arabic-translated versions of GOHAI and OHIP-14 can be regarded as effective measures for assessing treatment outcomes of complete denture therapy.

Monoallelic characteristic-bearing heterozygous L1053X in BRCA2 gene among Sudanese women with breast cancer.

BACKGROUND: Breast cancer (BC) is the most common type of cancer in women. Among many risk factors of BC, mutations in BRCA2 gene were found to be the primary cause in 5-10% of cases. The majority of deleterious mutations are frameshift or nonsense mutations. Most of the reported BRCA2 mutations are protein truncating mutations. METHODS: The study aimed to describe the pattern of mutations including single nucleotide polymorphisms (SNPs) and variants of the BRCA2 (exon11) gene among Sudanese women patients diagnosed with BC. In this study a specific region of BRCA2 exon 11 was targeted using PCR and DNA sequencing. RESULTS: Early onset cases 25/45 (55.6%) were premenopausal women with a mean age of 36.6 years. Multiparity was more frequent within the study amounting to 30 cases (66.6%), with a mean parity of 4.1. Ductal type tumor was the predominant type detected in 22 cases (48.8%) among the reported histotypes. A heterozygous monoallelic nonsense mutation at nucleotide 3385 was found in four patients out of 9, where TTA codon was converted into the stop codon TGA. CONCLUSION: This study detected a monoallelic nonsense mutation in four Sudanese female patients diagnosed with early onset BC from different families. Further work is needed to demonstrate its usefulness in screening of BC.

Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional study.

BACKGROUND: Female genital mutilation/cutting (FGM/C) is a cultural practice that involves several types of removal or other injury to the external female genitalia for nonmedical reasons. Although much international research has focused on the health consequences of the practice, little is known about sexual functioning among women with various types of FGM/C. OBJECTIVE: To assess the impact of FGM/C on the sexual functioning of Sudanese women. STUDY DESIGN: This is a cross-sectional study conducted at Doctor Erfan and Bagedo Hospital, Jeddah, Saudi Arabia. Eligible women completed a survey and a clinical examination, which documented and verified women's type of FGM/C. The main outcome measure was female sexual function, as assessed by the Arabic Female Sexual Function Index. RESULTS: A total of 107 eligible women completed the survey and the gynecological examination, which revealed that 39% of the women had FGM/C Type I, 25% had Type II, and 36% had Type III. Reliability of self-report of the type of FGM/C was low, with underreporting of the extent of the procedure. The results showed that 92.5% of the women scored lower than the Arabic Female Sexual Function Index cut-off point for sexual dysfunction. The multivariable regression analyses showed that sexual dysfunction was significantly greater with more extensive type of FGM/C, across all sexual function domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) and overall. CONCLUSION: The study documents that a substantial proportion of women subjected to FGM/C experience sexual dysfunction. It shows that the anatomical extent of FGM/C is related to the severity of sexual dysfunction.

Undoing female genital cutting: perceptions and experiences of infibulation, defibulation and virginity among Somali and Sudanese migrants in Norway.

This paper explores the dynamics of change in meaning-making about female genital cutting among migrants from Somalia and Sudan residing in Norway. In both countries, female genital cutting is almost universal, and most women are subjected to the most extensive form - infibulation - which entails the physical closure of the vulva. This closure must later be re-opened, or defibulated, to enable sexual intercourse and childbirth. Defibulation can also ease other negative health consequences of the practice. In Norway, surgical defibulation is provided on demand by the public health services, also beyond the traditional contexts of marriage and childbirth. This study explores experiences and perceptions of premarital defibulation. It explores whether Somali and Sudanese men and women understand defibulation as a purely medical issue or whether their use of the services is also affected by the cultural meaning of infibulation. This study analyses data from in-depth interviews with 36 women and men of Somali and Sudanese origin as well as participant observation conducted in various settings during 2014-2015. It reports that although all of the informants displayed negative attitudes towards infibulation, cultural meanings associated with virginity and virtue constitute a significant barrier to the uptake of premarital defibulation.