Research Papers
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Item Effects of gum Arabic ingestion on body mass index and body fat percentage in healthy adult females: two-arm randomized, placebo controlled, double-blind trial(Nutrition Journal, 2012) Babiker,Rasha; Merghani,Tarig H; Elmusharaf,Khalifa; Badi,Rehab M; Lang,Florian; Saeed,Amal MBackground: Gum Arabic (acacia Senegal) is a complex polysaccharide indigestible to both humans and animals. It has been considered as a safe dietary fiber by the United States, Food and Drug Administration (FDA) since the 1970s. Although its effects were extensively studied in animals, there is paucity of data regarding its quantified use in humans. This study was conducted to determine effects of regular Gum Arabic (GA) ingestion on body mass index and body fat percentage among healthy adult females. Methods: A two-arm randomized, placebo controlled, double-blind trial was conducted in the Department of Physiology at the Khartoum University. A total of 120 healthy females completed the study. They were divided to two groups: A test group of 60 volunteers receiving GA (30 gm /day) for 6 weeks and a placebo group of 60 volunteers receiving pectin (1 gm/day) for the same period of time. Weight and height were measured before and after intervention using standardized height and weight scales. Skin fold thickness was measured using Harpenden Skin fold caliper. Fat percentage was calculated using Jackson and Pollock 7 caliper method and Siri equation. Results: Pre and post analysis among the study group showed significant reduction in BMI by 0.32 (95% CI: 0.17 to 0.47; P<0.0001) and body fat percentage by 2.18% (95% CI: 1.54 to 2.83; P<0.0001) following regular intake of 30 gm /day Gum Arabic for six weeks. Side effects caused by GA ingestion were experienced only in the first week. They included unfavorable viscous sensation in the mouth, early morning nausea, mild diarrhea and bloating abdomen. Conclusions: GA ingestion causes significant reduction in BMI and body fat percentage among healthy adult females. The effect could be exploited in the treatment of obesity.Item Causes of end stage renal failure among haemodialysis patients in Khartoum State/Sudan(2015) Banaga,Amin S. I; Mohammed,Elaf B; Siddig,Rania M; Salama,Diana E; Elbashir,Sara B; Khojali,Mohamed O; Babiker,Rasha A; Elmusharaf,Khalifa; Homeida,Mamoun MBackground: End stage renal failure (ESRF) has become a major health problem in Sub Saharan Africa (SSA). There were limited data about causes of ESRF in the Sudan. Methods: This is a cross sectional hospital based descriptive study. The subjects of the study are ESRF adults’ patients on regular haemodialysis treatment in 15 haemdoialysis centres in Khartoum State—Sudan. Clinical and epidemio- logical data were obtained from 1583 patients. The medical files of each patient were reviewed to identify the cause of ESRF. Concerning the causes of ESRF, diabetes was diagnosed based on the past medical history and result of the glucose tolerance test, hypertension was diagnosed based on past history of hypertension based on blood pressure of more than 140/90 mmHg, glomerulonephritis was diagnosed based on results of previous kidney biopsies and on clinical grounds, polycystic kidney disease and obstructive uropathy were diagnosed based on abdominal ultrasound and other imaging modalities, sickle cell anaemia was diagnosed based on the result of haemoglobin electrophoresis, systemic lupus erythematosus was diagnosed based on the clinical criteria in addition to lab results of auto antibod- ies, and analgesic nephropathy was diagnosed based on past medical history of chronic analgesic drugs usage with no other identifiable risk factors. We included all ESRF patients on regular haemodialysis treatment. We excluded ESRF patients less than 18 years old. Results: The results showed that the mean age of ESRF Patients was 49 ± 15.8 (years) and 63.4 % were male and 76.3 % were unemployed. The mean duration of haemodialysis is 4.38 ± 4.24 (years). The most common cause of ESRF in our patients was hypertension (34.6 %) followed by chronic glomerulonephritis (17.6 %), diabetes mellitus (12.8 %), obstructive uropathy (9.6 %), autosomal dominant poly cystic kidney disease (ADPKD) (4.7 %), chronic pyelonephritis (4.6 %), analgesic nephropathy (3.5 %). However in (10.7 %) no cause was found. In patient aged less than 40 years old the leading cause of ESRF was glomerulonephritis (29.3 %) followed by hypertension (25 %). In patient aged between 40 to 60 years old the leading cause of ESRF was hypertension (38.5 %) followed by diabetes mellitus (14 %). In patient aged older than 60 years the leading cause of ESRF was hypertension (38.4 %) followed by diabetes mellitus (23.3 %). Conclusions: ESRF in Sudan affects the economically productive age group; unemployment rate among ESRF patients is high. The study showed that hypertension is a leading cause of ESRF in Sudan followed by chronic glomer- ulonephritis. Hypertension and diabetes mellitus are the leading causes of ESRF among patients over 40 years old.Item Metabolic effects of Gum Arabic (Acacia Senegal) in patients with Type 2 Diabetes Mellitus (T2DM): Randomized, placebo controlled double blind trial(2017) Babiker,Rasha; Elmusharaf,Khalifa; Keogh,Michael B; Banaga,Amin S. I; Saeed,Amal MBackground: Gum Arabic (GA) is a water-soluble dietary fiber, indigestible to both humans and animals. While GA currently does not have any therapeutic potential, it has nutritional value and some effects on metabolism of glucose and lipids. Thus, the aim of this study is to assess the effect of GA on serum level of glucose, lipids, and the BMI in type 2 diabetic patients. Methods: A double-blind randomized placebo-controlled trial took place at Academy Charity Teaching Hospital (ACTH) in Sudan between August 2014 to February 2015. The trial was conducted in type 2 diabetic patients who were on regular oral hypoglycemic drugs and had HbA1C ≥ 6.5%. Patients excluded from the study included those on insulin, any patient with a metabolic or gastrointestinal disease, and any patient with history of drug addiction and alcoholism. Other patients excluded were patients who had previous allergic reactions to GA in addition to patients who were pregnant or planned for conception within 6 months. 120 patients were invited to participate in this trial. 100 patients gave consent and were randomized to GA and placebo groups. The GA group was given 30 g of Acacia Senegal and the placebo group was given 5 g of placebo daily for 3 months. The outcomes assessed were primarily the effect of GA on glucose levels in addition to the effects on levels of lipids and BMI in type 2 diabetic patients. Results: The GA group showed significant reduction in fasting plasma glucose (FPG) and HbA1c (P<0.05) within the GA group. Moreover, GA supplementation improved lipid profiles; decreased LDL-Cholesterol by 5.95%, total Cholesterol by 8.28% and triglyceride by 10.95% from baseline levels. HDL-Cholesterol showed significant increase by 19.89% within GA group (P<0.05), BMI was decreased significantly by 2.06% (95% CI: −0.98; −0.16), P<0.05). Conclusions: Gum Arabic is a dietary supplement for improving nutrition of type 2 diabetic patients; it has demonstrated a good effect on improving their poor glycemic control. It has also shown improvement in the levels of the lipids and the BMI. Further studies are needed in obese and pre-diabetic patients to evaluate GA therapeutic potentials.Item Prevalence and Presentation of Tuberculosis among Hemodialysis Patients in Khartoum, Sudan(Saudi Journal of Kidney Diseases and Transplantation, 2016) Banaga,Amin S. I; Siddiq,Nihad K; Alsayed,Randa T; Babiker,Rasha; Elmusharaf,KhalifaABSTRACT. Tuberculosis (TB) is a major health problem in the developing countries. There are limited data about the prevalence of TB patients on maintenance hemodialysis (HD) in Sudan. The aim of this study is to identify the prevalence and presentation of TB among Sudanese maintenance HD patients. This is a hospital-based descriptive study. The participants of the study are all HD patients distributed in 13 HD centers in Khartoum and Khartoum North Provinces in Sudan. All patients attended the HD centers from November 1, 2014 to February 1, 2015, were interviewed by a questionnaire focused on personal and clinical data. Those who were diagnosed as having active TB were studied regarding their clinical presentation, presence of comorbidities, site of TB, and methods used on diagnosis. The total number of HD patients during the study period was 1328 patients. We found 19 patients who already diagnosed and treated for TB infec- tion. The prevalence rate of TB among HD patients is 1.4%. The mean age of patient was 44.53 ±8.69 years, 89.5% of them were males. The majority of them have comorbidities: 31.6%% have hypertension and 21.1% have diabetes. Extrapulmonary TB was the major presentation (57.9%) mainly tuberculous lymphadenitis (26.3%). The pulmonary presentation was found to be 42.1%. The diagnosis of TB was supported by microbiological evidence of alcohol acid-fast Bacilli pre- sent in sputum smear (21%), histological diagnosis (31.6%), polymerase chain reaction (21%), and imaging in (26.3%). Patients on maintenance HD are at an increased risk of TB and diagnosis of TB among HD patients need a high index of suspicion. There is a great need for establishing a screening scheme for TB among HD patients and further epidemiological studies are needed to fully evaluate this problem.Item Why Did Sudanese End Stage Renal Failure Patients Refuse Renal Transplantation?(Open Journal of Nephrology, 2015) Banaga,Amin S; Mohammed,Elaf B; Siddig,Rania M; Salama,Diana E; Elbashir,Sara B; Khojali,Mohamed O; Babiker,Rasha A; Elmusharaf,Khalifa; Homeida,Mamoun MRenal transplantation remains the most effective treatment of End Stage Renal Failure (ESRF). In this cross sectional study we explore the reasons behind refusal of renal transplantation among adults’ Sudanese haemodialysis patients. The subjects of the study are ESRF adults’ patients on regular haemodialysis treatment in 15 haemdoialysis centres in Khartoum/Sudan. All patients who are on regular haemodialysis were interviewed by questionnaire to explore the reasons of refusal of renal transplantation. A total of 1583 ESRF adults’ patients on regular haemodialysis have been participated in the study, 381 (24.1%) patients refused kidney transplantation. The mean age of patients refusing kidney transplantation was (58.5 + 15.1 years); 77.4% of them were ≥50 years old, 59.2% were males and 88.1% were unemployed, patients older than 50 years old and unemployed are tend to refuse renal transplantation (P < 0.001). The main reason of refusal was that the patients refuse to accept kidney from living donors (34.8%). 17.6% of patients de- cline kidney transplantation because of financial reason, 18.1% of patients refused to do trans- plantation because of fear of transplant surgery, 15.7% of patients believe that kidney transplan- tation is against their religious values, 11.9% of patients refused transplantation because they don’t have enough knowledge on renal transplantation, only 0.5% of patients refuse transplanta- tion because of side effect of immunosuppressive drugs. In conclusion, in this study we found that elderly and unemployed ESRF patients tend to refuse renal transplantation, the most important reason behind refusal of renal transplantation is refusal of accepting kidney donation from living related donors. This reflects the need for development of cadaveric donors program in the Sudan. ESRF patients need education and counseling on renal transplantation.