Aflatoxin M1 in raw and imported powdered milk sold in Khartoum state, Sudan.

The aim of this study is to determine the level of contamination of aflatoxin M1 (AFM1) in raw and imported powdered milk in Khartoum state, Sudan. Thirty-five samples of fresh cow milk were collected from different farms, based on the source of concentrated feed introduced to the dairy cows (locally vs. commercially produced) and the size of the farm (≤ 50 vs. >50 cows/farm). Also 12 samples of powdered milk were obtained from repacking companies in Khartoum state. The samples were analysed by a fluorometer, using the Vicam method. AFM1 was detected in all raw and powdered milk samples. Almost 50% of the contaminated powdered milk samples and all the raw milk samples exceeded the European Union limit of 0.05 µg/kg whereas 33% of the contaminated powdered milk samples and 77% of the raw milk samples exceeded the limit of Codex regulations (0.5 µg/kg). The results revealed that the concentration of AFM1 is affected significantly (P < 0.05) by the source of concentrated feed (locally produced or purchased) but not by the farm size. It was concluded that the levels of AFM1 in the milk samples indicated that the feeds offered to the cows were contaminated with aflatoxin B1 to such a level that it might cause a serious health problem to the public. Therefore, there is a need to limit the exposure to aflatoxin by imposing regulatory limits, as well as further studies on large scale bases are needed to investigate the amount of AFM1 in milk and dairy products.

Coarctation of the aorta in infancy and childhood.

The management and results of treatment in 181 children with coarctation of the aorta are presented. In this series, 79% of the patients presented in the first year of life and 55% presented as neonates. One hundred and fifty patients were operated on, with a total surgical mortality of 21%. Only one surgical death occurred in those operated on after 3 months of age. The higher mortality in young infants is closely related to associated cardiac anomalies and to the frequency of aortic and isthmal hypoplasia. Our findings suggest that neonates presenting with heart failure and coarctation should be operated on early, as the surgical mortality under 6 weeks is 45%, whereas there is an 86% mortality in neonates who were not operated on. Analysis of follow-up indicates that when operation can be performed electively the optimal period for sugical treatment is between 6 months and 1 year of age. If operation is performed after this age, there may be persistent systemic hypertension despite relief of aortic obstruction.

Assessment of Doppler ultrasound to measure systolic and diastolic blood pressures in infants and young children.

A recently developed instrument uses the Doppler shift technique to detect vessel wall movement, and it has been suggested that in conjunction with a conventional sphygmomanometer systolic and diastolic blood pressures can be measured. A controlled study was carried out in 20 children recovering from cardiac surgery where direct intra-arterial measurements (one observer) were compared with independent measurements using the Doppler instrument (2 observers). Systolic pressures measured directly and by Doppler technique correlated well and there was no significant difference between intra-arterial and indirect measurements whether the latter were taken by doctors or by nurses. In contrast, direct and indirect diastolic pressure measurements correlated poorly and were significantly overestimated with a mean difference of 6-25 mmHg (range +25 to -10) for doctors, and 4-25 mmHg (range +20 to -10) for nurses. Thus, the instrument adequately measured systolic blood pressure, but in our hands did not give precise measurements for diastolic blood pressure.