Hatim Mudawi | University of Khartoum (original) (raw)

Papers by Hatim Mudawi

Research paper thumbnail of Prevalence of hepatitis B virus infection in the Gezira State of Central Sudan

Saudi Journal of Gastroenterology, 2007

This is a cross-sectional study to determine the prevalence and risk factors for transmission of ... more This is a cross-sectional study to determine the prevalence and risk factors for transmission of hepatitis B virus (HBV) infection in the Gezira state of central Sudan prior to the introduction of blood screening and vaccination against HBV. The study was carried out on the population of Um Zukra village in Gezira state of Central Sudan. The village was surveyed on five consecutive days in Dec 2000. Epidemiological characteristics were recorded and participants were interviewed for risk factors of viral hepatitis. Blood samples were then collected and tested for HBsAg and HBcAb. A total of 404 subjects were screened with a mean age of 35 years; 54.9% were females, HBsAg and HBcAb were reactive in 6.9% and 47.5% of the studied population, respectively. Exposure to HBV increased with increasing age. The only significant risk factor for transmission of infection was a history of parenteral antischistosomal therapy. This study shows that prevalence of HBV infection is high in the studied population and it is hoped that introduction of blood screening and vaccination against HBV would decrease the carrier pool in the next few years.

Research paper thumbnail of Presentation and management outcome of inflammatory bowel disease in Sudan

Tropical gastroenterology : official journal of the Digestive Diseases Foundation

This is a retrospective study conducted at the National Center for Gastrointestinal and Liver dis... more This is a retrospective study conducted at the National Center for Gastrointestinal and Liver disease in Khartoum, Sudan on patients diagnosed with inflammatory bowel disease (IBD) during the period between January 1990 and May 2001. The study was conducted to determine the pattern of presentation and management outcome of inflammatory bowel disease (IBD) among Sudanese patients. All patients underwent a colonoscopy/ sigmoidoscopy with histopathological diagnosis, or a barium study. Seventy three patients were diagnosed as Ulcerative colitis (UC), and twelve patients as Crohn's disease (CD). The majority of our patients with UC improved with medical treatment. We concluded that IBD is not a rare disease in Sudan, UC being more common than CD. The disease tends to be more common in men in both UC and CD.

Research paper thumbnail of Familial achalasia in Sudan

PubMed, Aug 12, 2004

An 8-month old Sudanese male child with a history of recurrent vomiting since the age of 4 months... more An 8-month old Sudanese male child with a history of recurrent vomiting since the age of 4 months was referred for upper gastrointestinal edoscopy, which showed a dilated oesophagus and a tight lower esophageal sphincter. The child was diagnosed as having achalasia, which was successfully treated with pneumatic dilatation under General anaesthesia.

Research paper thumbnail of Molecular characterization and genotyping of hepatitis C virus from Sudanese end-stage renal disease patients on haemodialysis

BMC Infectious Diseases

Background Hepatitis C virus (HCV) is a global public health problem, with ~ 11 million people in... more Background Hepatitis C virus (HCV) is a global public health problem, with ~ 11 million people in Africa infected. There is incomplete information on HCV in Sudan, particularly in haemodialysis patients, who have a higher prevalence compared to the general population. Thus, our objectives were to genotype and molecularly characterize HCV isolated from end-stage renal disease haemodialysis patients. Methods A total of 541 patients were recruited from eight haemodialysis centres in Khartoum and screened for anti-HCV. Viral loads were determined using in-house real-time PCR in seropositive patients. HCV was genotyped and subtyped using sequencing of amplicons of 5′ untranslated (UTR) and non-structural protein 5B (NS5B) regions, followed by phylogenetic analysis of corresponding sequences. Results The HCV seroprevalence in the study was 17% (93/541), with HCV RNA-positive viremic rate of 7% (40/541). A low HCV load, with a mean of 2.85 × 104 IU/ml and a range of 2.95 × 103 to 4.78 × 10...

Research paper thumbnail of Histopathological features of coeliac disease in a sample of Sudanese patients

The Malaysian journal of pathology, 2016

Coeliac disease can occur at any age but is more common in children. Its diagnosis requires corre... more Coeliac disease can occur at any age but is more common in children. Its diagnosis requires correlation between clinical presentations, serological results, endoscopic findings and histopathological classification using the modified Marsh grading system. This study of coeliac disease with biopsies received in the department of histopathology at Soba University Hospital, and Fedail Hospital aimed to gain insight into the demographic profile, clinical presentations and histopathological classification of patients with coeliac disease. This was a descriptive study carried out at Soba University Hospital and Fedail Hospital during the period from January 2010-December 2013. Haematoxylin & Eosin and CD3-stained slides of small intestinal biopsies of coeliac disease patients were reviewed for various histological features (1) intraepithelial lymphocytes (IEL) count per 100 enterocytes, (2) crypt hyperplasia and (3) degree of villous atrophy. Based on the histopathological findings, the ca...

Research paper thumbnail of Gastro-oesophageal reflux disease in Sudan: a clinical endoscopic and histopathological study

Tropical gastroenterology : official journal of the Digestive Diseases Foundation

This study was conducted to assess the frequency of gastroesophageal reflux disease (GERD) and Ba... more This study was conducted to assess the frequency of gastroesophageal reflux disease (GERD) and Barrett's esophagus among Sudanese patients with clinical symptoms of heartburn. One hundred and five patients were included in the study; forty seven patients had evidence of reflux oesophagitis, 61.7% of whom had grade B oesophagitis according to the modified Los Angeles classification and 10.6% had Barrett's oesophagus. 78.7% of the biopsies from the esophageal cardia revealed presenced of inflammation (Carditis). Dysplasia was documented in 21.3% of these biopsies. Helicobacter pylori was detected 59.6% of gastrooesophageal reflux disease patients and 56.8% of patients with carditis. However, 80% of patients with Barrett oesophagus were positive for Helicobacter pylori. It was concluded that gastro-oesophageal reflux disease affects all age groups with males being affected more than females and Helicobacter pylori infection did not play a major role in gastro-oesophageal reflux...

Research paper thumbnail of Molecular characterization of hepatitis B virus in liver disease patients and asymptomatic carriers of the virus in Sudan

BMC Infectious Diseases, Jul 18, 2013

Background: Hepatitis B virus is hyperendemic in Sudan. Our aim was to molecularly characterize h... more Background: Hepatitis B virus is hyperendemic in Sudan. Our aim was to molecularly characterize hepatitis B virus from Sudanese individuals, with and without liver disease, because genotypes play an important role in clinical manifestation and treatment management. Methods: Ninety-nine patients-30 asymptomatic, 42 cirrhotic, 15 with hepatocellular carcinoma, 7 with acute hepatitis and 5 with chronic hepatitis-were enrolled. Sequencing of surface and basic core promoter/precore regions and complete genome were performed. Results: The mean ± standard deviation, age was 45.7±14.8 years and the male to female ratio 77:22. The median (interquartile range) of hepatitis B virus DNA and alanine aminotransferase levels were 2.8 (2.2-4.2) log IU/ml and 30 (19-49) IU/L, respectively. Using three genotyping methods, 81/99 (82%) could be genotyped. Forty eight percent of the 99 patients were infected with genotype D and 24% with genotype E, 2% with putative D/E recombinants and 7% with genotype A. Patients infected with genotype E had higher frequency of hepatitis B e antigen-positivity and higher viral loads compared to patients infected with genotype D. Basic core promoter/precore region mutations, including the G1896A in 37% of HBeAg-negative individuals, could account for hepatitis B e antigen-negativity. Pre-S deletion mutants were found in genotypes D and E. Three isolates had the vaccine escape mutant sM133T. Conclusion: Sudanese hepatitis B virus carriers were mainly infected with genotypes D or E, with patients infected with genotype E having higher HBeAg-positivity and higher viral loads. This is the first study to molecularly characterize hepatitis B virus from liver disease patients in Sudan.

Research paper thumbnail of The prevalence of neurological complications among adult Sudanese patients with chronic liver disease

Sudan medical journal, 1970

Objective We aimed to study the prevalence of neurological complications among adult Sudanese pat... more Objective We aimed to study the prevalence of neurological complications among adult Sudanese patients with chronic liver disease (CLD) seen in Ibn Sina Hospital (Sudan) (February 2005 - February 2006). Patients & Methods This is a prospective descriptive cross sectional hospital based study. Ninety six adult Sudanese patients with CLD were included in the study. All patients had been subjected to full detailed history, proper clinical examination and necessary investigations including EEG, Brain CT, MRI, NCS and EMG. Result: Male to female ratio was (2.5:1). Splenomegally was observed in 71patients (74%), shrunken liver in 83 (86.5%), 74 (77.1%) had ascites. Sixty percent had liver cirrhosis, 24% had cirrhosis with periportal fibrosis (PPF). Hepatocellular Carcinoma (HCC) was detected in 12 patients. Out of 96 patients with CLD, neurological complications were detected in 44 (45.8%), acute hepatic encephalopathy ranging from grade I to grade IV was found to be the most common neuro...

Research paper thumbnail of Paediatric gastrointestinal endoscopy: experience in a Sudanese university hospital

Eastern Mediterranean Health Journal, 2009

Research paper thumbnail of Hepatitis B virus/HIVirus co-infection in Africa: Our experience in South Africa and Sudan

Journal of Clinical Virology, 2015

Background: Increasing evidence suggests that pattern recognition receptor (PRR) agonists could b... more Background: Increasing evidence suggests that pattern recognition receptor (PRR) agonists could be used as immunomodulatory agents to control viral infection. We addressed the questions whether NOD1 or NOD2 ligand induces hepatitis B virus (HBV) clearance in a hydrodynamic injection (HI) mouse model. Methods: HI of pAAV/HBV1.2 in C57BL/6 mice leads to a transient HBV gene expression and replication in the liver. Different doses of NOD1/NOD2 ligand or NS were administered by HI or intraperitoneally (IP) or intramuscularly (IM) 14 day post pAAV/HBV1.2 injection. Serological markers of HBV infection were assayed at the indicated time points by ELISA. Serum HBV DNA was quantified by real time PCR. CD molecules and cytokine mRNAs in mouse liver tissues were detected by real-time RT-PCR. Liver tissue sections were stained with anti-HBc antibodies. The frequencies of antigen-specific interferon ␥ secreting splenocytes were measured by using ELISPOT assay. Findings: Only doses of 20 g NOD1 ligand delivered by HI significantly reduced HBsAg and HBV DNA levels in the animals. By contrast, the serum HBsAg and HBeAg levels in mice receiving NOD1 ligand by IP or IM injection or in mice receiving NOD2 ligand by HI, IP, or IM injection were not reduced compared with those receiving the NS control. The numbers of HBcAg positive hepatocytes were decreased by NOD1 treatment, compared with those in the NS group. The levels of CD3/CD4/CD8/perforin/IL6/CXCL2/CCL5 mRNAs were higher in liver of NOD1 ligand-treated mice when compared with those of control mice. The frequencies of antigenspecific interferon ␥ secreting cells were higher in the NOD1 ligand-treated mice. Interpretation: NOD1 ligand inhibits HBV replication in C57BL/6 mice when injected by HI, primarily due to the enhancement of a T cell response, implicating the potential of NOD1 activation for the treatment of chronic hepatitis B patients.

Research paper thumbnail of Prevalence of hepatitis B virus infection in the Gezira State of Central Sudan

Saudi Journal of Gastroenterology, 2007

This is a cross-sectional study to determine the prevalence and risk factors for transmission of ... more This is a cross-sectional study to determine the prevalence and risk factors for transmission of hepatitis B virus (HBV) infection in the Gezira state of central Sudan prior to the introduction of blood screening and vaccination against HBV. The study was carried out on the population of Um Zukra village in Gezira state of Central Sudan. The village was surveyed on five consecutive days in Dec 2000. Epidemiological characteristics were recorded and participants were interviewed for risk factors of viral hepatitis. Blood samples were then collected and tested for HBsAg and HBcAb. A total of 404 subjects were screened with a mean age of 35 years; 54.9% were females, HBsAg and HBcAb were reactive in 6.9% and 47.5% of the studied population, respectively. Exposure to HBV increased with increasing age. The only significant risk factor for transmission of infection was a history of parenteral antischistosomal therapy. This study shows that prevalence of HBV infection is high in the studied population and it is hoped that introduction of blood screening and vaccination against HBV would decrease the carrier pool in the next few years.

Research paper thumbnail of (160) Predictors of responses to adefovir therapy in patients with lamivudine-resistant hepatitis B virus YMDD mutant before and after liver transplantation

Arab Journal of Gastroenterology, 2009

Research paper thumbnail of Acute schistosomal colitis preceded by Katayama syndrome

Journal of Digestive Endoscopy

ABSTRACTSchistosomiasis is prevalent in tropical and subtropical areas. It manifests as an acute ... more ABSTRACTSchistosomiasis is prevalent in tropical and subtropical areas. It manifests as an acute or chronic illness caused by the body’s reaction to the worms’ eggs. In view of its clinical similarity to various other diseases, the disorder may cause diagnostic errors. We present a case of a Sudanese man, who presented with fever, headache, fatigue, myalgia, excessive sweating, abdominal cramps, and a high eosinophil count on blood testing. He was diagnosed with a connective tissue disorder and was started on prednisolone, but 3 weeks later, he presented with rectal bleeding. Colonoscopy showed features of moderate distal colitis. Colonic biopsies revealed several viable schistosome ova associated with aggregates of eosinophils, compatible with active colonic schistosomiasis.

Research paper thumbnail of Chemotherapy induced small bowel obstruction in small cell lung cancer

Arab Journal of Gastroenterology

Research paper thumbnail of Correlation Between Serum Hepatitis B Surface Antigen Quantification and Serum Hepatitis B DNA Levels in Sudanese Patients With Chronic Hepatitis B Virus Infection

American Journal of Gastroenterology

Research paper thumbnail of Mortality and rebleeding following variceal haemorrhage in liver cirrhosis and periportal fibrosis

World Journal of Hepatology, 2016

Clinical trial registration statement: Not applicable, there were no interventions in this study.... more Clinical trial registration statement: Not applicable, there were no interventions in this study. Informed consent statement: All participants in the study or their legal guardian provided their informed consent before being enrolled in the study.

Research paper thumbnail of Indications and findings of colonoscopy in patients presenting to the endoscopy unit at Soba University Hospital in Khartoum, Sudan

Background and study aimsThe new endoscopy unit at Soba University Hospital in Khartoum, Sudan is... more Background and study aimsThe new endoscopy unit at Soba University Hospital in Khartoum, Sudan is an emerging unit, established in June 2003. In 2004 less than 200 colonoscopies were performed , the number rising to over 700 colonoscopies in 2009. The objectives of this study were to identify the common indications and findings in patients attending for colonoscopy and to

Research paper thumbnail of Addison's disease due to Histoplasma duboisii infection of the adrenal glands

Saudi medical journal, 2008

Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. In the normal individual, ... more Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. In the normal individual, both disseminated histoplasmosis and symptomatic adrenal histoplasmosis are rare. Herein, we describe the case of a 50-year-old gentleman residing in western Sudan who presented with a 7-month history of generalized body weakness, easy fatigue, and frequent attacks of vomiting and diarrhea. Physical examination and laboratory investigations confirmed the diagnosis of Addison's disease due to Histoplasma capsulatum var duboisii infection of the adrenal glands. He was treated with intravenous hydrocortisone, followed by oral prednisolone and itraconazole.

Research paper thumbnail of Appropriate use and diagnostic yield of upper gastrointestinal endoscopy in a tertiary referral hospital

Arab Journal of Gastroenterology, 2012

This is a prospective, descriptive, hospital-based study to evaluate the appropriateness and diag... more This is a prospective, descriptive, hospital-based study to evaluate the appropriateness and diagnostic yield of upper gastrointestinal (GI) tract endoscopy referrals to Soba University Hospital endoscopy unit using the American Society for Gastrointestinal Endoscopy guidelines for appropriate use of endoscopy. All patients referred to Soba University Hospital for upper GI endoscopy during the study period were enrolled in the study after giving an informed consent. Statistical analysis was done using the Statistical Package for Social Sciences (SPSS) program to calculate frequencies and the X(2) test; P value was taken as significant at a level of less than 0.05. Overall, 220 patients were prospectively enrolled in the study, of which 126 (57%) were males, with a mean age of 46.5 ± 17.9 years. A total of 190 patients (86%) were appropriately referred and the overall diagnostic yield was 46.8%. Those with appropriate referral had a higher diagnostic yield (50%) when compared to those with inappropriate referral (23%). The diagnostic yield of upper GI endoscopy was higher when patients were referred appropriately indicating that detection of relevant finding is greatly enhanced by the utilisation of standard guidelines.

Research paper thumbnail of Fulminant Hepatic Failure in an African Setting: Etiology, Clinical Course, and Predictors of Mortality

Digestive Diseases and Sciences, 2007

This is prospective cross-sectional study on 37 patients presenting to different hospitals in Kha... more This is prospective cross-sectional study on 37 patients presenting to different hospitals in Khartoum state, Sudan, sought to determine the etiology, clinical course, and predictors of mortality in patients presenting with fulminant hepatic failure (FHF). Patients were subclassified into hyperacute, acute, and subacute FHF; all sera were tested for hepatitis A, B, C, and E; negative samples were tested for antinuclear antibodies and anti-smooth muscle antibodies. The commonest etiologic factors included seronegative hepatitis (38%), hepatitis B virus (22%), severe Plasmodium falciparum malaria (8%), autoimmune hepatitis (8%), hepatitis E virus (5%), anti-tuberculous drugs (5%), and lymphomatous infiltration of the liver (5%). The mortality rate was high at 84%. Poor prognostic factors included presentation with grade III/IV encephalopathy, evidence of bacterial infection, and a prolonged prothrombin time of >25 seconds over the controls.

Research paper thumbnail of Prevalence of hepatitis B virus infection in the Gezira State of Central Sudan

Saudi Journal of Gastroenterology, 2007

This is a cross-sectional study to determine the prevalence and risk factors for transmission of ... more This is a cross-sectional study to determine the prevalence and risk factors for transmission of hepatitis B virus (HBV) infection in the Gezira state of central Sudan prior to the introduction of blood screening and vaccination against HBV. The study was carried out on the population of Um Zukra village in Gezira state of Central Sudan. The village was surveyed on five consecutive days in Dec 2000. Epidemiological characteristics were recorded and participants were interviewed for risk factors of viral hepatitis. Blood samples were then collected and tested for HBsAg and HBcAb. A total of 404 subjects were screened with a mean age of 35 years; 54.9% were females, HBsAg and HBcAb were reactive in 6.9% and 47.5% of the studied population, respectively. Exposure to HBV increased with increasing age. The only significant risk factor for transmission of infection was a history of parenteral antischistosomal therapy. This study shows that prevalence of HBV infection is high in the studied population and it is hoped that introduction of blood screening and vaccination against HBV would decrease the carrier pool in the next few years.

Research paper thumbnail of Presentation and management outcome of inflammatory bowel disease in Sudan

Tropical gastroenterology : official journal of the Digestive Diseases Foundation

This is a retrospective study conducted at the National Center for Gastrointestinal and Liver dis... more This is a retrospective study conducted at the National Center for Gastrointestinal and Liver disease in Khartoum, Sudan on patients diagnosed with inflammatory bowel disease (IBD) during the period between January 1990 and May 2001. The study was conducted to determine the pattern of presentation and management outcome of inflammatory bowel disease (IBD) among Sudanese patients. All patients underwent a colonoscopy/ sigmoidoscopy with histopathological diagnosis, or a barium study. Seventy three patients were diagnosed as Ulcerative colitis (UC), and twelve patients as Crohn's disease (CD). The majority of our patients with UC improved with medical treatment. We concluded that IBD is not a rare disease in Sudan, UC being more common than CD. The disease tends to be more common in men in both UC and CD.

Research paper thumbnail of Familial achalasia in Sudan

PubMed, Aug 12, 2004

An 8-month old Sudanese male child with a history of recurrent vomiting since the age of 4 months... more An 8-month old Sudanese male child with a history of recurrent vomiting since the age of 4 months was referred for upper gastrointestinal edoscopy, which showed a dilated oesophagus and a tight lower esophageal sphincter. The child was diagnosed as having achalasia, which was successfully treated with pneumatic dilatation under General anaesthesia.

Research paper thumbnail of Molecular characterization and genotyping of hepatitis C virus from Sudanese end-stage renal disease patients on haemodialysis

BMC Infectious Diseases

Background Hepatitis C virus (HCV) is a global public health problem, with ~ 11 million people in... more Background Hepatitis C virus (HCV) is a global public health problem, with ~ 11 million people in Africa infected. There is incomplete information on HCV in Sudan, particularly in haemodialysis patients, who have a higher prevalence compared to the general population. Thus, our objectives were to genotype and molecularly characterize HCV isolated from end-stage renal disease haemodialysis patients. Methods A total of 541 patients were recruited from eight haemodialysis centres in Khartoum and screened for anti-HCV. Viral loads were determined using in-house real-time PCR in seropositive patients. HCV was genotyped and subtyped using sequencing of amplicons of 5′ untranslated (UTR) and non-structural protein 5B (NS5B) regions, followed by phylogenetic analysis of corresponding sequences. Results The HCV seroprevalence in the study was 17% (93/541), with HCV RNA-positive viremic rate of 7% (40/541). A low HCV load, with a mean of 2.85 × 104 IU/ml and a range of 2.95 × 103 to 4.78 × 10...

Research paper thumbnail of Histopathological features of coeliac disease in a sample of Sudanese patients

The Malaysian journal of pathology, 2016

Coeliac disease can occur at any age but is more common in children. Its diagnosis requires corre... more Coeliac disease can occur at any age but is more common in children. Its diagnosis requires correlation between clinical presentations, serological results, endoscopic findings and histopathological classification using the modified Marsh grading system. This study of coeliac disease with biopsies received in the department of histopathology at Soba University Hospital, and Fedail Hospital aimed to gain insight into the demographic profile, clinical presentations and histopathological classification of patients with coeliac disease. This was a descriptive study carried out at Soba University Hospital and Fedail Hospital during the period from January 2010-December 2013. Haematoxylin & Eosin and CD3-stained slides of small intestinal biopsies of coeliac disease patients were reviewed for various histological features (1) intraepithelial lymphocytes (IEL) count per 100 enterocytes, (2) crypt hyperplasia and (3) degree of villous atrophy. Based on the histopathological findings, the ca...

Research paper thumbnail of Gastro-oesophageal reflux disease in Sudan: a clinical endoscopic and histopathological study

Tropical gastroenterology : official journal of the Digestive Diseases Foundation

This study was conducted to assess the frequency of gastroesophageal reflux disease (GERD) and Ba... more This study was conducted to assess the frequency of gastroesophageal reflux disease (GERD) and Barrett's esophagus among Sudanese patients with clinical symptoms of heartburn. One hundred and five patients were included in the study; forty seven patients had evidence of reflux oesophagitis, 61.7% of whom had grade B oesophagitis according to the modified Los Angeles classification and 10.6% had Barrett's oesophagus. 78.7% of the biopsies from the esophageal cardia revealed presenced of inflammation (Carditis). Dysplasia was documented in 21.3% of these biopsies. Helicobacter pylori was detected 59.6% of gastrooesophageal reflux disease patients and 56.8% of patients with carditis. However, 80% of patients with Barrett oesophagus were positive for Helicobacter pylori. It was concluded that gastro-oesophageal reflux disease affects all age groups with males being affected more than females and Helicobacter pylori infection did not play a major role in gastro-oesophageal reflux...

Research paper thumbnail of Molecular characterization of hepatitis B virus in liver disease patients and asymptomatic carriers of the virus in Sudan

BMC Infectious Diseases, Jul 18, 2013

Background: Hepatitis B virus is hyperendemic in Sudan. Our aim was to molecularly characterize h... more Background: Hepatitis B virus is hyperendemic in Sudan. Our aim was to molecularly characterize hepatitis B virus from Sudanese individuals, with and without liver disease, because genotypes play an important role in clinical manifestation and treatment management. Methods: Ninety-nine patients-30 asymptomatic, 42 cirrhotic, 15 with hepatocellular carcinoma, 7 with acute hepatitis and 5 with chronic hepatitis-were enrolled. Sequencing of surface and basic core promoter/precore regions and complete genome were performed. Results: The mean ± standard deviation, age was 45.7±14.8 years and the male to female ratio 77:22. The median (interquartile range) of hepatitis B virus DNA and alanine aminotransferase levels were 2.8 (2.2-4.2) log IU/ml and 30 (19-49) IU/L, respectively. Using three genotyping methods, 81/99 (82%) could be genotyped. Forty eight percent of the 99 patients were infected with genotype D and 24% with genotype E, 2% with putative D/E recombinants and 7% with genotype A. Patients infected with genotype E had higher frequency of hepatitis B e antigen-positivity and higher viral loads compared to patients infected with genotype D. Basic core promoter/precore region mutations, including the G1896A in 37% of HBeAg-negative individuals, could account for hepatitis B e antigen-negativity. Pre-S deletion mutants were found in genotypes D and E. Three isolates had the vaccine escape mutant sM133T. Conclusion: Sudanese hepatitis B virus carriers were mainly infected with genotypes D or E, with patients infected with genotype E having higher HBeAg-positivity and higher viral loads. This is the first study to molecularly characterize hepatitis B virus from liver disease patients in Sudan.

Research paper thumbnail of The prevalence of neurological complications among adult Sudanese patients with chronic liver disease

Sudan medical journal, 1970

Objective We aimed to study the prevalence of neurological complications among adult Sudanese pat... more Objective We aimed to study the prevalence of neurological complications among adult Sudanese patients with chronic liver disease (CLD) seen in Ibn Sina Hospital (Sudan) (February 2005 - February 2006). Patients & Methods This is a prospective descriptive cross sectional hospital based study. Ninety six adult Sudanese patients with CLD were included in the study. All patients had been subjected to full detailed history, proper clinical examination and necessary investigations including EEG, Brain CT, MRI, NCS and EMG. Result: Male to female ratio was (2.5:1). Splenomegally was observed in 71patients (74%), shrunken liver in 83 (86.5%), 74 (77.1%) had ascites. Sixty percent had liver cirrhosis, 24% had cirrhosis with periportal fibrosis (PPF). Hepatocellular Carcinoma (HCC) was detected in 12 patients. Out of 96 patients with CLD, neurological complications were detected in 44 (45.8%), acute hepatic encephalopathy ranging from grade I to grade IV was found to be the most common neuro...

Research paper thumbnail of Paediatric gastrointestinal endoscopy: experience in a Sudanese university hospital

Eastern Mediterranean Health Journal, 2009

Research paper thumbnail of Hepatitis B virus/HIVirus co-infection in Africa: Our experience in South Africa and Sudan

Journal of Clinical Virology, 2015

Background: Increasing evidence suggests that pattern recognition receptor (PRR) agonists could b... more Background: Increasing evidence suggests that pattern recognition receptor (PRR) agonists could be used as immunomodulatory agents to control viral infection. We addressed the questions whether NOD1 or NOD2 ligand induces hepatitis B virus (HBV) clearance in a hydrodynamic injection (HI) mouse model. Methods: HI of pAAV/HBV1.2 in C57BL/6 mice leads to a transient HBV gene expression and replication in the liver. Different doses of NOD1/NOD2 ligand or NS were administered by HI or intraperitoneally (IP) or intramuscularly (IM) 14 day post pAAV/HBV1.2 injection. Serological markers of HBV infection were assayed at the indicated time points by ELISA. Serum HBV DNA was quantified by real time PCR. CD molecules and cytokine mRNAs in mouse liver tissues were detected by real-time RT-PCR. Liver tissue sections were stained with anti-HBc antibodies. The frequencies of antigen-specific interferon ␥ secreting splenocytes were measured by using ELISPOT assay. Findings: Only doses of 20 g NOD1 ligand delivered by HI significantly reduced HBsAg and HBV DNA levels in the animals. By contrast, the serum HBsAg and HBeAg levels in mice receiving NOD1 ligand by IP or IM injection or in mice receiving NOD2 ligand by HI, IP, or IM injection were not reduced compared with those receiving the NS control. The numbers of HBcAg positive hepatocytes were decreased by NOD1 treatment, compared with those in the NS group. The levels of CD3/CD4/CD8/perforin/IL6/CXCL2/CCL5 mRNAs were higher in liver of NOD1 ligand-treated mice when compared with those of control mice. The frequencies of antigenspecific interferon ␥ secreting cells were higher in the NOD1 ligand-treated mice. Interpretation: NOD1 ligand inhibits HBV replication in C57BL/6 mice when injected by HI, primarily due to the enhancement of a T cell response, implicating the potential of NOD1 activation for the treatment of chronic hepatitis B patients.

Research paper thumbnail of Prevalence of hepatitis B virus infection in the Gezira State of Central Sudan

Saudi Journal of Gastroenterology, 2007

This is a cross-sectional study to determine the prevalence and risk factors for transmission of ... more This is a cross-sectional study to determine the prevalence and risk factors for transmission of hepatitis B virus (HBV) infection in the Gezira state of central Sudan prior to the introduction of blood screening and vaccination against HBV. The study was carried out on the population of Um Zukra village in Gezira state of Central Sudan. The village was surveyed on five consecutive days in Dec 2000. Epidemiological characteristics were recorded and participants were interviewed for risk factors of viral hepatitis. Blood samples were then collected and tested for HBsAg and HBcAb. A total of 404 subjects were screened with a mean age of 35 years; 54.9% were females, HBsAg and HBcAb were reactive in 6.9% and 47.5% of the studied population, respectively. Exposure to HBV increased with increasing age. The only significant risk factor for transmission of infection was a history of parenteral antischistosomal therapy. This study shows that prevalence of HBV infection is high in the studied population and it is hoped that introduction of blood screening and vaccination against HBV would decrease the carrier pool in the next few years.

Research paper thumbnail of (160) Predictors of responses to adefovir therapy in patients with lamivudine-resistant hepatitis B virus YMDD mutant before and after liver transplantation

Arab Journal of Gastroenterology, 2009

Research paper thumbnail of Acute schistosomal colitis preceded by Katayama syndrome

Journal of Digestive Endoscopy

ABSTRACTSchistosomiasis is prevalent in tropical and subtropical areas. It manifests as an acute ... more ABSTRACTSchistosomiasis is prevalent in tropical and subtropical areas. It manifests as an acute or chronic illness caused by the body’s reaction to the worms’ eggs. In view of its clinical similarity to various other diseases, the disorder may cause diagnostic errors. We present a case of a Sudanese man, who presented with fever, headache, fatigue, myalgia, excessive sweating, abdominal cramps, and a high eosinophil count on blood testing. He was diagnosed with a connective tissue disorder and was started on prednisolone, but 3 weeks later, he presented with rectal bleeding. Colonoscopy showed features of moderate distal colitis. Colonic biopsies revealed several viable schistosome ova associated with aggregates of eosinophils, compatible with active colonic schistosomiasis.

Research paper thumbnail of Chemotherapy induced small bowel obstruction in small cell lung cancer

Arab Journal of Gastroenterology

Research paper thumbnail of Correlation Between Serum Hepatitis B Surface Antigen Quantification and Serum Hepatitis B DNA Levels in Sudanese Patients With Chronic Hepatitis B Virus Infection

American Journal of Gastroenterology

Research paper thumbnail of Mortality and rebleeding following variceal haemorrhage in liver cirrhosis and periportal fibrosis

World Journal of Hepatology, 2016

Clinical trial registration statement: Not applicable, there were no interventions in this study.... more Clinical trial registration statement: Not applicable, there were no interventions in this study. Informed consent statement: All participants in the study or their legal guardian provided their informed consent before being enrolled in the study.

Research paper thumbnail of Indications and findings of colonoscopy in patients presenting to the endoscopy unit at Soba University Hospital in Khartoum, Sudan

Background and study aimsThe new endoscopy unit at Soba University Hospital in Khartoum, Sudan is... more Background and study aimsThe new endoscopy unit at Soba University Hospital in Khartoum, Sudan is an emerging unit, established in June 2003. In 2004 less than 200 colonoscopies were performed , the number rising to over 700 colonoscopies in 2009. The objectives of this study were to identify the common indications and findings in patients attending for colonoscopy and to

Research paper thumbnail of Addison's disease due to Histoplasma duboisii infection of the adrenal glands

Saudi medical journal, 2008

Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. In the normal individual, ... more Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. In the normal individual, both disseminated histoplasmosis and symptomatic adrenal histoplasmosis are rare. Herein, we describe the case of a 50-year-old gentleman residing in western Sudan who presented with a 7-month history of generalized body weakness, easy fatigue, and frequent attacks of vomiting and diarrhea. Physical examination and laboratory investigations confirmed the diagnosis of Addison's disease due to Histoplasma capsulatum var duboisii infection of the adrenal glands. He was treated with intravenous hydrocortisone, followed by oral prednisolone and itraconazole.

Research paper thumbnail of Appropriate use and diagnostic yield of upper gastrointestinal endoscopy in a tertiary referral hospital

Arab Journal of Gastroenterology, 2012

This is a prospective, descriptive, hospital-based study to evaluate the appropriateness and diag... more This is a prospective, descriptive, hospital-based study to evaluate the appropriateness and diagnostic yield of upper gastrointestinal (GI) tract endoscopy referrals to Soba University Hospital endoscopy unit using the American Society for Gastrointestinal Endoscopy guidelines for appropriate use of endoscopy. All patients referred to Soba University Hospital for upper GI endoscopy during the study period were enrolled in the study after giving an informed consent. Statistical analysis was done using the Statistical Package for Social Sciences (SPSS) program to calculate frequencies and the X(2) test; P value was taken as significant at a level of less than 0.05. Overall, 220 patients were prospectively enrolled in the study, of which 126 (57%) were males, with a mean age of 46.5 ± 17.9 years. A total of 190 patients (86%) were appropriately referred and the overall diagnostic yield was 46.8%. Those with appropriate referral had a higher diagnostic yield (50%) when compared to those with inappropriate referral (23%). The diagnostic yield of upper GI endoscopy was higher when patients were referred appropriately indicating that detection of relevant finding is greatly enhanced by the utilisation of standard guidelines.

Research paper thumbnail of Fulminant Hepatic Failure in an African Setting: Etiology, Clinical Course, and Predictors of Mortality

Digestive Diseases and Sciences, 2007

This is prospective cross-sectional study on 37 patients presenting to different hospitals in Kha... more This is prospective cross-sectional study on 37 patients presenting to different hospitals in Khartoum state, Sudan, sought to determine the etiology, clinical course, and predictors of mortality in patients presenting with fulminant hepatic failure (FHF). Patients were subclassified into hyperacute, acute, and subacute FHF; all sera were tested for hepatitis A, B, C, and E; negative samples were tested for antinuclear antibodies and anti-smooth muscle antibodies. The commonest etiologic factors included seronegative hepatitis (38%), hepatitis B virus (22%), severe Plasmodium falciparum malaria (8%), autoimmune hepatitis (8%), hepatitis E virus (5%), anti-tuberculous drugs (5%), and lymphomatous infiltration of the liver (5%). The mortality rate was high at 84%. Poor prognostic factors included presentation with grade III/IV encephalopathy, evidence of bacterial infection, and a prolonged prothrombin time of >25 seconds over the controls.