Ibrahim Abdelmajeed Ginawi

Screening for tuberculosis and its histological pattern in patients with enlarged lymph node.

Settings. Tuberculosis is a major health problem in the Republic of Yemen. Tuberculous lymphadenitis is one of the most common forms of extrapulmonary tuberculosis. Therefore, this retrospective descriptive study was conducted in Yemen to investigate the morphological pattern of tuberculous lymphadenitis, as well as to assess the reliability measures of (ZN) Ziehl-Neelsen and fluorescent methods in identification of Mycobacterium tuberculosis. Methodology. One hundred lymph nodes tissue biopsies that were previously diagnosed by conventional histopathology as having tuberculous lymphadenitis were reinvestigated. Five micron in thickness sections were obtained from formalin-fixed paraffin wax processed tissues. The sections were stained using Haematoxylin and eosin (H & E), ZN, and fluorescent methods. Results. All of the 100 specimens were proved as having histopathological pattern of tuberculosis lymphadenitis. The most major histological features were giant cell (88%), caseation (84%), epithelioid cells (80%), granuloma and caseation (68%), lymphocytes (31%), and histiocytes (4%). After staining the specimens with ZN and fluorescent, of the 100 specimens only 3 (3%) and 9 (9%) specimens were found positive, by ZN and fluorescent methods, respectively. Conclusion. Conventional ZN and fluorescent methods have limitations in diagnosis of tuberculous lymphadenitis due to their lower sensitivity. Histopathology remains the most suitable method for the diagnosis of tuberculous lymphadenitis. In cases of suspected tuberculous lymphadenitis, it is advisable to confirm with more sensitive and specific method, such as polymerase chain reaction PCR or immunohistochemistry before reporting the negative results.

Prevalence of Obesity in Hail Region, KSA: In a Comprehensive Survey

Background. Obesity contributes significantly to morbidity and mortality rates worldwide. We, therefore, aimed to provide epidemiological data on the prevalence of obesity in Hail, Kingdom of Saudi Arabia (KSA). Methodology. Data were collected during cross-sectional survey which included 5000 Saudi selected from 30 primary health care centers (PHCs) in Hail Region. Results. The overall prevalence of obesity in Hail was 63.6%. Moreover, the prevalence of males was 56.2% and the prevalence of females was 71%. Conclusion. Obesity is prevalent in the Hail Region which necessitates urgent interventions including health education.

Occupational exposures to aluminum and iron and risk of lung epithelium atypia in sudan

This study investigated the risk of lung cytological atypical changes in regards to occupational exposure to aluminum and iron. Detailed job histories were elicited from 130 incident cases with confirmed exposure to aluminum (50) or iron (80) and 157 population controls (nonexposed). Cytological atypia in sputum (dysplasia) was identified in four cases and none of controls (RR =10.8550; 95% CI = 0.5898 to 199.7815, P = 0.1086), hence, metaplasia was observed among 15 (11.5%) of the cases and 10 (6%) of controls (RR = 1.8115; 95% CI = 0.8424–3.8956; P = 0.1283). Evidences of viral infection were observed in 18 (14%) of the cases and 8 (5%) of controls (RR = 2.7173; 95% CI = 1.2213–6.0460; P = 0.0143). Moniliasis was observed in 28 (22%) of the cases and 19 (12%) of controls (RR = 1.6632; 95% CI = 0.9728–2.8435; P = 0.06). Cross‐categorizations of aluminum exposure and iron use suggest greater risk associated with iron exposure than aluminum in these workers. Diagn. Cytopathol. 2013.

Non-Alcoholic Fatty Liver Disease in Africa and Middle East: An Attempt to Predict the Present and Future Implications on the Healthcare System

Non-alcoholic fatty liver disease (NAFLD) encompasses a group of hepatic diseases that range in severity. NAFLD is increasingly recognized as an epidemic among different populations, including those in Africa and the Middle East. The objective of this narrative review is to document the prevalence of and risk factors for NAFLD in Africa and the Middle East and the potential implications on the healthcare systems. An in-depth search on Google Scholar, Medline and PubMed was conducted using the terms “non-alcoholic fatty liver disease” and “non-alcoholic steatohepatitis”, in addition to “prevalence and risk factors for NAFLD”, with special emphasis on Africa and the Middle East countries. There were three types of epidemiological studies that included prevalence, risk factors and management/complications of NAFLD. There was noticeable variation in the prevalence of NAFLD among different countries, based on the variation in the prevalence of risk factors (type 2 diabetes, obesity, metabolic syndrome and dyslipidemia) and the diagnostic tool used in the study. However, the highest prevalence rate was reported in some Middle East countries. In Africa, there were few studies about NAFLD and most reported variable prevalence rates. There is an increasing prevalence of NAFLD as a result of the increasing risk factors, particularly in the Middle East, while in Africa, the situation is still unclear. Health providers in these regions are faced with many challenges that need urgent plans.

Immunophenotyping of HPV Types 16 and 18 among Sudanese Patients with Oral Lesions

OBJECTIVE The aim of this study was to screen patients with oral lesions for the presence of Human Papilloma Virus (HPV) types 16 and 18. METHODS Sixty patients aged between 11-80 years with a mean age of 46 years were examined using immunohistological techniques. All samples were retrieved from RICK during the period from August 2009 to August 2010. Out of 60 patients, 50 had Oral Squamous Cell Carcinomas (OSCCs) and the remaining ten had benign oral lesions, included as internal control. RESULTS Of the 50 patients with OSCCs, 10 (20%) showed positive immunohistochemical results for HPV types 16 and 18 of which 50% were detected among males and 50% were demonstrated among females. The ten positive findings were Immunophenotyped as follows: five were positive with HPV type 16, four with type 18 and one was positive for HPV types 16 and18. All patients with benign oral lesions were negative for HPV immunohistochemistry. CONCLUSION The study suggests the role of HPV 16 and 18 in the etiology of oral cancers in different parts of Sudan. However, the use of molecular techniques such as PCR are needed to confirm the results of immunohistochemistry in the role of the HPV in developing of OSCC in Sudan.

Focal and segmental glomerulosclerosis in murine models: a histological and ultrastructural characterization with immunohistochemistry correlation of glomerular CD44 and WT1 expression

ABSTRACT Aim: Focal segmental glomerulosclerosis (FSGS) is a common progressive chronic renal disease. Podocyte injury and loss are the postulated pivotal events that trigger FSGS. In this study, the authors aim to examine the evolution of FSGS in murine models histologically, ultrastructurally and immunohistochemically with special emphasis on podocytes and parietal epithelial cells (PECs). Material and methods: FSGS resembling primary FSGS in humans was initiated in Wistar rats using intravenous Adriamycin injections. Blood and urine analysis were performed at 0, 8, and 12 weeks. Both the control kidneys and the test kidneys were harvested at 8 and 12 weeks, examined histologically and ultrastructurally and the findings correlated with the glomerular expression of immunostains specific for podocytes (WT-1) and for activated PECs (CD44). Results: FSGS developed in both 8 and 12 weeks test groups showing progressive proteinuria, podocytopathy and segmental glomerular scarring. There was a decrease in the glomerular expression of WT-1 with a concurrent increase in the glomerular expression of CD44, indicating podocyte loss with synchronous increase in activated PECs. The evolving FSGS correlated negatively with podocytes and positively with activated PECs. Conclusion: Our study shows that with podocyte injury there is podocyte effacement and loss, proteinuria, glomerular segmental adhesion and scarring, all culminating in FSGS. In addition, there is activation, hyperplasia and hypertrophy of PECs. This demonstrates that both podocyte loss and PEC activation promote FSGS. Our findings are consistent with recent investigations. More studies are required to further understand the role of these cells in the evolution of FSGS and subsequently introduce new targeted treatment modalities.

The Impact of Diabetes on Acute Post-Infectious Glomerulonephritis in Rats: An Experimental Study with Literature Review

Background: The concurrence of diabetes and nephritogenic infections may have a tremendous impact on the kidney. The approach to the two concurrent diseases is based on histological, immunofluorescence findings and most importantly on ultrastructural features. In this experiment our aim was to compare the pattern of injury seen in the kidney in animals with induced post-infectious glomerulonephritis with and without associated diabetes. Methods: We divided 48 Wistar species rats into four groups comprising twelve rats each. Group I is the normal control, group II includes the rats with induced diabetes, group III are the rats with acute post-infectious glomerulonephritis (APIG), while group IV includes the rats with induced diabetes and APIG. Streptozocin was used to induce diabetes in groups II and IV while neutral phosphatase toxin (NPTase) of Staphylococcus strain was used in groups III and IV. Groups III and IV were sacrificed three and ten days after infection. Routine, immunofluorescence and ultrastructural stains and studies were performed on the kidneys of all rats. Serum urea and creatinine and urinary protein were estimated in all groups. Results: Out of the forty-eight rats initially included in the study, only twenty-four survived the experiment: three in Group I, five in Group II, five in Group III and eleven in Group IV. The most relevant and distinguishing findings in cases of APIG with associated diabetes are the earlier and more prominent infiltration by polymorphonuclear cells, the stronger positivity for IgG and the earlier and more extensive presence of dense deposits which were confirmed by the electron microscopy study. Conclusions: This experiment ascertains the adverse effects of diabetes in cases of acute post-infectious glomerulonephritis, in terms of onset and severity of the disease. The necessity of a better control of the glucose level may not only decrease the incidence of acute post-infectious glomerulonephritis but may also contribute to the development of a milder form of the disease.