Prediction of Acute Renal Failure in Dengue Fever Patients

Background: Dengue virus (DENV) infection is caused by an arboviral strain and is transmitted by the mosquito Aedes aegypti which is found in Sudan especially Red Sea and Kassala states in the east. The disease is known to cause renal disturbances and a thorough understanding of that will potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted in the Eastern Sudan College of Medical Science and Technology and Port Sudan Teaching Hospital. 200 confirmed Dengue virus infected patients along with 200 healthy appearing adults (control) were enrolled for the study. Statistical analysis was carried out after the collection of patients’ demographic, clinical, and investigational data including serum urea and creatinine values. Ethical approval was obtained from the ministry of health, Red Sea state and informed written consent was obtained from each participant. Results: The highest incidence of DENV infection was observed in individuals of the middle age group (29%). Elevated blood urea levels were detected in 10 (5%) patients while elevated creatinine levels were seen in 17 (8.5%) patients. Although fallen within reference ranges found in the literature, mean blood urea and creatinine values differed significantly between patients and controls and between different categories of the disease. Mean blood urea concentration showed a statistically significant difference between the control (22.3 mg/dl) and the test (28.4 mg/dl) (P value Conclusion: We strongly conclude that renal involvement is not uncommon in Dengue fever and that blood urea and creatinine evaluation should be considered in the counseling of DENV infection patients. Patients need to be subjected to necessary laboratory investigations associated with acute kidney injury to decrease the rate of morbidity and mortality associated with the disease.

Significance of Serum Electrolyte Pattern in an Eastern Sudanese Dengue Fever Patients Population

Background: Dengue virus (DENV) infection is caused by an arboviral strain and is transmitted by the mosquito Aedes Egyties which is found in Sudan especially Red Sea and Kassala states in the east. In the year 2020 there was a significant outbreak in the both states. The disease is known to cause renal and electrolyte disturbances and a thorough understanding of that which will potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted in the Eastern Sudan College of Medical Science and Technology and Port Sudan Teaching Hospital. 200 confirmed Dengue virus infection patients along with 200 healthy appearing adults (as a control) were enrolled for the study. Statistical analysis was carried out after the collection of patients’ demographic, clinical, and investigational data including electrolyte values. Results: The highest incidence of DENV infection was observed in individuals of the middle age group (29%). Although fallen within reference ranges found in the literature, mean serum electrolyte values differed significantly between patients and controls and between different categories of the disease. For our patients, hyponatraemia was seen in 43.5%, hypokalaemia in 37%, hypocalcaemia in 30%, hypophosphataemia in 12% and low magnesium concentrations in 13%. Mean serum sodium concentration differed in the control (138.2 mmol/l) from in the test (132.5 mmol/l) (P. value 0.02). Similarly, mean serum potassium in the control (3.97 mmol/l) differed significantly (P. value 0.01) from test (3.30 mmol/l). Mean calcium and phosphorus (8.80 and 3.50 mg/dl) in the control were also differed from test (8.51 and 3.30), (P. values 0.02 and 0.004, respectively). In contrast, serum magnesium (mg/dl) in the control group (1.96) showed no significant difference from that of test group (1.90) (P. value 0.08). The biochemical parameters studied were neither affected by age nor by gender of the patient group. Clinically, fever was present in 97.5% of patient, headache in 95.5%, joints pain in 71%, lethargy 67%, vomiting in 49%, skin rash in 40%, abdominal pain 24% and bleeding in 17.5%. Conclusion: We strongly conclude that electrolyte evaluation should be considered in the counseling of DENV infected patients. Patients need to be subjected to necessary laboratory investigations including serum electrolyte levels to decrease the rate of morbidity and mortality associated with the disease.

The Frequency of rs1799889 in Plasminogen Activator Inhibitor Type-1 Gene in Sudanese Type 2 Diabetic Patients, Gezira State, Sudan, 2020-2021

Background and Objectives: The cornerstone of the regulation fibrinolytic system is plasminogen activator inhibitor type-1. The 4G/5G polymorphism in the PAI-1 gene is a key genetic predictor of increased plasma levels which is the most polymorphism associated with cardiovascular complications. The 4G carriers have six times higher PAI-1 levels than 5G carriers leading to an increase in the level of plasma inhibitor by about 25% more than 5G allele (wide type). Type 2 diabetes presents symptoms of hypercoagulability and hypofibrinolytic system that lead to contribute in the atherothrombosis and then the myocardial infarction (MI). These findings supported the hypothesis that there is a link between diabetes patients and this SNP. There is no data about the prevalence of this allele in Sudanese diabetic patients with type 2 and the allele differs in prevalence according to ethnicity, for these reasons, the aim of this study was to determine the allele and genotype frequency of the rs1799889 among Sudanese T2DM patients. Methods: A case-control study was conducted using 70 diagnosed diabetes type 2 patients and 50 healthy individuals as the control group. AS-PCR technique was used to genotype the rs1799889, and the allelic frequency was calculated according to Hardy-Weinberg equilibrium. Allelic frequencies were assessed using gene counting (SNP-STAT software V. Release 3.13), and genotypes were scored. Results: The result showed that 4G allele frequency was 28% among Sudanese diabetic patients without statistical difference when compared with control group (P-value = 0.998) but, high when compared with other studies in African population 13% and very low when compared with white and Indian populations studies. Conclusion: By this study, the allele frequency was higher in Sudanese diabetic patients with type 2, and also we need another study to evaluate the effect of this polymorphism in thrombophilic complications in Sudanese diabetic patients with type 2.

Decidual Natural Killer Cells Are Essential for a Successful Pregnancy (Review)

Pregnancy is a complex physiological process involving several interconnected systems. Many researchers were concerned that the formation of a fetus with different genetic components may contradict the normal state of immunity, which attempts to reject and fight foreign bodies. This piqued the interest of biologists and immunologists, who set out to discover the immune system’s composition and mode of response in the uterus. According to several studies, natural killer (NK) cells are present in a significant percentage that differs from what is seen in peripheral blood. As a result, several scientific studies have been conducted on uterine NK cells, investigating their types, characteristics, receptors, secretions, and interactions with the surrounding environment. Research has also indicated the capacity of uterine NK cells to strike a balance between eradicating uterine infections and effectively contributing to different phases of pregnancy. Various studies have shown that NK cell activity is intimately related to the success or failure of pregnancy. In this review, we describe the uterine NK cell subtypes;decidual (dNK) cells and endometrial NK cells (eNK) cells and their important role during different phases of pregnancy.