El-tahihir .A.G.doc

UNIVERSITY OF GEZIRA Deanship of Graduate Studies And Scientific Research Department of Biochemistry & nutrition Micronutrients Profiles of Sudanese patient with kala-azar Gedarif east Sudan Hayat Ahmed Elmahi (B.Sc., M.Sc.) :Supervisor Professor Khalid El-tom Ali :Co-supervisors Professor El-Tahir Awad Gasim Khalil Professor Osman Khalaf Alla Saeed Associate Professor Ahmed Mudawi Musa A thesis submitted for the fulfillment of PhD degree in Nutritional Biochemistry, University of Gazira Dedica
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  UNIVERSITY OF GEZIRADeanship of Graduate StudiesAnd Scientific ResearchDepartment of iochemistr! nutrition#icronutrients $rofi%es of Sudanese patient &ith 'a%a(a)ar Gedarif eastSudan*a!at Ahmed E%mahi +,Sc,- #,Sc,.Super/isor 0$rofessor 1ha%id E%(tom A%i2o(super/isors0 $rofessor E%(Tahir A&ad Gasim 1ha%i%$rofessor Osman 1ha%af A%%a Saeed Associate $rofessor Ahmed #uda&i #usaA thesis su3mitted for the fu%fi%%ment of $hD de4ree in Nutritiona%iochemistr!- Uni/ersit! of Ga)ira  Dedication I dedicate this &or' to m! %o/in4 #other as an! success andachie/ements I accomp%ish are the resu%t of her 'ind %o/e and carin4heart- to sou% of m! Father &ho made sure that a%% his chi%dren are &e%%educated and am3itious- to m! hus3and for his end%ess support and patience to m! t&o dau4hters for their support- %o/e and assistance- tom! a%% fami%! and friends for their support and encoura4ement toaccomp%ish this &or' , 5  Specia% dedication to the peop%e sufferin4 of 1a%a(A)ar and for e/er!mother and father &ho %ost a chi%d- for that &e shou%d ha/e done more totreat this dead%! disease,A3stract0 Background: Zinc -copper Iron are essentia% for norma% human de/e%opment andfunctionin4 of the 3od!, The! ha/e 3een imp%icated to p%a! importantro%es in immune(ph!sio%o4ic functions, 6*O +5778. ,There are /er!fe& studies that ha/e addressed 3et&een V,9 and micronutrient statusinteractionsViscera% %eishmaniasis +V9. is a fata% form of 9, dono/ani infections thataffects interna% or4ans, The disease is an important cause of mor3idit!and morta%it! that is fata% if not treated, Nutritiona% factors are c%aimed tocontri3ute 4reat%! to V9 suscepti3i%it! and mor3idit!:morta%it!, #icro(nutrients deficiencies ha/e 3een associated &ith a num3er of diseases, Aims: This stud! is underta'en to e;p%ore the %e/e% of )inc- copper Iron as&e%% as )inc:copper ratio amon4 V,9 patients <  Materials & Methods: This case(contro% stud! &as carried out in eastern Sudan in Gedarif state- Eastern Sudan an area that is endemic for V9 +1a%a(a)ar.Fo%%o&in4 informed consent- <=< &ith parasito%o4ica%%! confirmed V9and 57> apparent%! hea%th comparators &ere enro%%ed, Recruitment &ascarried out at 1assa3 Rura% *ospita%- &here %!mph nodes and 3onemarro& aspirates are the routine methods for V9 dia4nosis,The stud! continued for three !ears +No/em3er <>>8 ?#arch <>>@.,Demo4raphic and c%inica% data- nutrition assessment and anthropometricmeasurements &ere co%%ected in a specia%%! desi4ned report forms,Venous 3%ood &as co%%ected and serum &as separated for 3iochemistr!-haemato%o4! and Iron- Zinc 2opper estimation, , $re4nant &omen-*IV I:II reacti/e- patients &ith acti/e pu%monar! T3 &ere e;c%uded , Results and discussion: The means a4e of V9 patients and the comparator &ere 5,8>B55,C>!ears and C,5 B5,= !ears respecti/e%!, The ma%e fema%e ratio in patients &as C0< compared to 50< in hea%th! contro%s, The mains!mptoms and si4ns are fe/er- &astin4 and anaemia &ith a meanduration of i%%ness of ,C<BC,5 &ee's The #I is si4nificant%! %o& in patients +5<,< B 8,5. compared &ith hea%th! contro%s +57,@BC,8. p /a%ue>,>>5, *3 is compara3%e @,5B5,7- 55,= B<,> +p /a%ue >,5.,The tota% serum protein and serum a%3umin in patients +8,= B5,C C,<B@.-are si4nificant%! %o&er compared to hea%th! contro%s +,< B>,@ C, B>,.+p /a%ues0 >,>< and >,>7 respecti/e%!.,Serum iron %e/e%s in patients and contro%s +=>,BC7,@- @>,=B<,8. andSerum Zin' %e/e%s +8, @B<@,- @7,8,=BCC. are %o&er in patientscompared to hea%th! contro%s +p /a%ue >,>>5., Serum 2opper %e/e%s in patients and contro%s are compara3%e +@,<BC,5- 8@,= B,<respecti/e%!. p /a%ue >,,2orre%ation 3et&een Zinc- copper- iron &ith disease duration Summary C  Serum iron &as found si4nificant%! %o&er in V9 patients compared tocomparators- there &as si4nificant corre%ation of %o& iron %e/e%s anddisease duration, The Zinc %e/e% &as si4nificant%! %o&er in patientscompared to comparators, There &as si4nificant corre%ation of %o& Zinc%e/e%s and disease duration, On the other hand 2opper is si4nificant%!hi4her in patients compared to comparators, There &as si4nificantcorre%ation of hi4h 2opper %e/e%s and disease duration, Conclusion and recommendations  Nutritiona% and micronutrient status ha/e %on4 3een 'no&n to inf%uencethe ris' of infectious diseases A%thou4h it is 'no&n that nutritiona% statusmi4ht inf%uence the outcome of different infections- , a%ancedmicronutrients supp%ementation durin4 V9 ma! positi/e%! impact theoutcome of the disease,1e!&ords Zinc- 2opper Iron Anemia- ma%nutrition- V,9 Gedarif -Sudan 
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