Asian Pacific Journal of Tropical Biomedicine

Issue 6,2015 Table of Contents

  • Display Type:
  • Text List
  • Abstract List
  • 1  Coriander (Coriandrum sativum L.) essential oil: Chemistry and biological activity
    Shyamapada Mandal Manisha Manda
    2015(6):421-428. DOI: 10.1016/j.apjtb.2015.04.001
    [Abstract](24) [HTML](0) [PDF 1.26 M](87)
    Abstract:
    Coriandrum sativum L. (C. sativum) is one of the most useful essential oil bearing spices as well as medicinal plants, belonging to the family Umbelliferae/Apiaceae. The leaves and seeds of the plant are widely used in folk medicine in addition to its use as a seasoning in food preparation. The C. sativum essential oil and extracts possess promising antibacterial, antifungal and anti-oxidative activities as various chemical components in different parts of the plant, which thus play a great role in maintaining the shelf-life of foods by preventing their spoilage. This edible plant is non-toxic to humans, and the C. sativum essential oil is thus used in different ways, viz., in foods (like flavouring and preservatives) and in pharmaceutical products (therapeutic action) as well as in perfumes (fragancias and lotions). The current updates on the usefulness of the plant C. sativum are due to scientific research published in different web-based journals.
    2  A review on metastatic breast cancer in Iran
    Hamidreza Alizadeh Otaghvar Mostafa Hosseini Adnan Tizmaghz Ghazaal Shabestanipour Hamid Noori
    2015(6):429-433. DOI: 10.1016/j.apjtb.2015.02.001
    [Abstract](28) [HTML](0) [PDF 324.10 K](76)
    Abstract:
    Metastatic breast cancer is a disease of early breast cancer that usually occurs several years after the early breast cancer. Breast cancer is the most common cancer among Iranian women. According to the new statistics in Iran 6160 breast cancers are diagnosed in the country each year and 1063 cases lead to death. In this paper, epidemiology, diagnosis and treatment have been investigated. In this study, case–control clinical trials and open studies with adequate data were collected. Due to the higher risk of age group 40–49 years and the advent of advanced breast cancer in Iranian women, the early diagnosis and determination of the exact size of the tumor before surgery is important in choosing a therapy plan. The decision on the therapy of invasive breast cancer depends on several factors such as cancer stage, tumor size and type, pathological and cytological status of the tumor, the patient's opinion, the presence or absence of estrogen and progesterone receptors in the cytoplasm of tumor cells and so on.
    3  H5N6 influenza virus infection, the newest influenza
    Beuy Joob Wiwanitkit Viroj
    2015(6):434-437. DOI: 10.1016/j.apjtb.2015.03.001
    [Abstract](20) [HTML](0) [PDF 278.99 K](84)
    Abstract:
    The most recent new emerging infection is the H5N6 influenza virus infection. This infection has just been reported from China in early May 2014. The disease is believed to be a cross species infection. All indexed cases are from China. Of interest, the H5N6 influenza virus is the primary virus for avian. The avian H5N6 influenza virus in avian population is a low virulent strain. However, the clinical manifestation in human seems severe. In this mini-review, the authors summarize and discuss on this new emerging influenza.
    4  Identification and preliminary characterization of non-polyene antibiotics secreted by new strain of actinomycete isolated from sebkha of Kenadsa, Algeria
    Omar Messaoudi Mourad Bendahou Ibrahim Benamar Djamal-Elddine Abdelwouhid
    2015(6):438-445. DOI: 10.1016/j.apjtb.2015.04.002
    [Abstract](32) [HTML](0) [PDF 837.84 K](78)
    Abstract:
    Objective: To study the antimicrobial activity of actinomycetes isolated from sabkha of Kenadsa and identification of the isolate interesting. Methods: Eighteen strains were isolated, using four culture media from sebkha of Kenadsa (Bechar, Southwestern Algeria). Screening of antimicrobial activity consisted of two steps: in primary screening, antibacterial activity was determined by using the agar plug method against test strains; in secondary screening, better isolate which showed a good activity in the first screening was selected to extract antimicrobial substances. The antimicrobial activities of extracts were evaluated by using Kirby–Bauer disc diffusion method. Partial characterization of antimicrobial products was performed on the basis of chemical revelations, UV–vis spectrometry and infrared spectroscopy. The identification of isolate interesting was performed through morphological, chemical, biochemical and physiological characteristics. Results: All isolates showed antimicrobial activity against at least one microorganism test. One isolate, LAM143cG3, was selected for its broad spectrum and high antimicrobial activity. The isolate LAM143cG3 was identified as Spirillospora sp. The comparison between the species of this genus (Spirillospora rubra and Spirillospora albida) and our isolate indicated the existence of several physiological and biochemical differences which led us to suppose that this was a new member of this genus. Primary characterization of antimicrobial substances produced by the isolate LAM143cG3 indicated the presence of amines and phenols. The UV–vis spectrum suggested a nonpolyenic nature of substances secreted by our isolate, while infrared confirmed the presence of amine groups. Conclusions: The result of the present study revealed that sebkha of Kenadsa was rich in rare actinomycetes, that secreted interesting antimicrobial substance.
    5  In vivo antiplasmodial and in vitro antioxidant properties of stem bark extracts of Haematostaphis barteri
    Johnson Nyarko Boampong Akua Afryie Karikari Elvis Ofori Ameyaw
    2015(6):446-450. DOI: 10.1016/j.apjtb.2015.02.002
    [Abstract](19) [HTML](0) [PDF 1019.97 K](77)
    Abstract:
    Objective: To evaluate the antimalarial and antioxidant properties of stem bark extracts of Haematostaphis barteri (H. barteri). Methods: The prophylactic activity of the plant was performed by dosing mice with sulfadoxine-pyrimethamine (1.2 mg/kg), aqueous extract (30, 100, 300 mg/kg) and dichloromethane/methanol (D/M) (30, 100, 300 mg/kg) extracts of H. barteri for 3 days. On the 4th day, the mice were inoculated with Plasmodium berghei. The parasite density was estimated for each mouse 72 h post-parasite inoculation. The curative activity of the plant was also performed by inoculating mice with Plasmodium berghei. Three days later, they were treated with artemether-lumefantrine (4 mg/kg), aqueous and D/M extracts of H. barteri stem bark for 5 days. The in vitro antioxidant property of the aqueous extract was determined by using the reducing power, nitric oxide and total antioxidant capacity assays. Results: The aqueous extract exerted significant (P < 0.05) curative and prophylactic antimalarial activities. The D/M extract exhibited significant curative (P < 0.05) but not prophylactic antiplasmodial effect. The aqueous extract exhibited in vitro antioxidant property with IC50's of (0.930 ± 0.021) mg/mL, (0.800 ± 0.001) mg/mL and (0.22 ± 0.05) mg/mL in the total antioxidant capacity, reducing power and nitric oxide assays. Histological assessment of the liver of aqueous and D/M treated animals did not reveal any sign of toxicity. Conclusions: H. barteri is not toxic which exerted significant curative antiplasmodial effects but the prophylactic property was however fraction dependent. The mechanism of the antiplasmodial activity of H. barteri may partly be mediated by its antioxidant property.
    6  Influence of Spirulina platensis exudates on the endocrine and nervous systems of a mammalian model
    Samah M.M. Fathy Ashraf M.M. Essa
    2015(6):451-457. DOI: 10.1016/j.apjtb.2015.03.002
    [Abstract](20) [HTML](0) [PDF 0.00 Byte](0)
    Abstract:
    Objective: To investigate the effect of intra-peritoneal injection of purified exudates of axenic Spirulina platensis on the mammalian endocrine and nervous systems. Methods: The intra-peritoneal injection of the cyanobacterial exudates in mice was applied. Sex hormonal levels of testosterone and progesterone were measured using radioimmunoassay while the follicular stimulating hormone and luteinizing hormone were evaluated by direct chemiluminescence. In addition, superoxide dismutase, catalase and glutathione peroxidase were monitored in the hippocampus region using spectrophotometric method. The levels of the hippocampal monoamines, dopamine, noradrenaline and serotonin were analyzed by high performance liquid chromatography while the acetyl choline neurotransmitter was measured by colorimetric method using choline/ acetylcholine assay kit. Results: A sharp disruption in the sex hormones levels of testosterone, progesterone, follicular stimulating hormone and luteinizing hormone was demonstrated in the serum of the treated mice. At the same time, a significant reduction in the endogenous antioxidant defense enzymes, superoxide dismutase, catalase and glutathione peroxidase was observed in the hippocampus region of the injected mice. Moreover, levels of dopamine, noradrenaline, serotonin and acetyl choline neurotransmitter in the same region were significantly affected as a result of the treatment with Spirulina filtrate. The gas chromatography–mass spectrometer and liquid chromatography mass spectrometry/mass spectrometry analysis showed the presence of some sterol-like compounds in the cyanobacterial filtrate. Conclusions: This study demonstrated the capability of Spirulina to release detrimental bioactive metabolites into their surrounding that can disrupt the mammalian endocrine and nervous systems.
    7  Phytochemistry of the essential oil of Melissa officinalis L. growing wild in Morocco: Preventive approach against nosocomial infections
    Zineb Jalal Yassine El Atki Badiaa Lyoussi Abdelfattah Abdellaoui
    2015(6):458-461. DOI: 10.1016/j.apjtb.2015.03.003
    [Abstract](17) [HTML](0) [PDF 0.00 Byte](0)
    Abstract:
    Objective: To determine the phytochemical characterization and antibacterial activity of Melissa officinalis essential oil against bacteria responsible for nosocomial infections. Methods: The phytochemical characterization of essential oil was evaluated using gas chromatography-flame ionization detector and gas chromatography-mass spectrometer analysis. Antibacterial activity of the oil was tested against four bacterial strains responsible for nosocomial infections: Pseudomonas aeruginosa, Klebsiella pneumonia, Staphylococcus aureus and Citrobacter koseri using disc diffusion method. Results: Thirty three components were identified representing 89.30% of the total oil composition. The yield of essential oil was 0.4% and the predominant components were citronellal (14.40%), isogeraniol (6.40%), geraniol acetate (10.20%), nerol acetate (5.10%), caryophyllene (8.10%) and β-caryophyllene oxide (11.00%). Antibacterial activity of the oil showed the higher activity against all bacterial strains tested. Conclusions: The essential oil extracted from lemon balm can be used to clean the environment of reanimation polyvalent and anaesthesia service.
    8  Hypoglycemic and antioxidant activities of Caesalpinia ferrea Martius leaf extract in streptozotocin-induced diabetic rats
    Sherien Kamal Hassan Nermin Mohammed El-Sammad Amria Mamdouh Mousa Maha Hashim Mohammed Abd el Razik Hussein Farrag Amani Nassir Eldin Hashim Victoria Werner Ulrike Lindequist Mahmoud Abd El-Moein Nawwar
    2015(6):462-471. DOI: 10.1016/j.apjtb.2015.03.004
    [Abstract](24) [HTML](0) [PDF 0.00 Byte](0)
    Abstract:
    Objective: To evaluate the antidiabetic and antioxidant effects of aqueous ethanolic extract of Caesalpinia ferrea (C. ferrea) leaf in normal and streptozotocin (STZ) induced diabetic rats. Methods: Male Sprague-Dawley rats divided into 6 groups of 6 rats each were assigned into diabetic and non-diabetic groups. Diabetes was induced in rats by single intraperitoneal administration of STZ (65 mg/kg body weight). C. ferrea extract at the doses of 250 and 500 mg/kg body weight was orally administered to both diabetic and nondiabetic animals for a period of 30 days. After completion of experimental duration serum, liver and pancreas were used for evaluating biochemical and histopathological changes. Results: Oral administration of C. ferrea leaf extract significantly reduced elevated serum glucose, α-amylase, liver function levels and significantly increased serum insulin, total protein and body weight as well as improved lipid profile due to diabetes. Furthermore, the treatment resulted in a marked increase in glutathione peroxidase, superoxide dismutase, catalase and reduced glutathione, and diminished levels of lipid peroxidation in liver and pancreas of diabetic rats. Histopathological studies demonstrated the reduction in the pancreas and liver damage and confirmed the biochemical findings. Conclusions: From the present study, it can be concluded that the C. ferrea leaf extract effectively improved hyperglycaemia while inhibiting the progression of oxidative stress in STZ-induced diabetic rats. Hence, it can be used in the management of diabetes mellitus.
    9  In vitro screening of 1-aryl-6-hydroxy-1,2,3,4-tetrahydroisoquinolines: Structure related activity against pathogenic bacteria
    Moses Njutain Ngemenya Joelle Ngo Hanna Julios Armand Komtchou Simon Mbua Ngale Efange
    2015(6):472-477. DOI: 10.1016/j.apjtb.2015.03.005
    [Abstract](18) [HTML](0) [PDF 0.00 Byte](0)
    Abstract:
    Objective: To evaluate the antibacterial activity of ten synthetic tetrahydroisoquinolines against eight bacterial strains. Methods: The ten tetrahydroisoquinolines synthesized via base-catalyzed Pictet–Spengler cyclization were screened against a total of eight bacterial strains comprising control and pathogenic strains by the disc diffusion and micro-dilution methods. The most active compound was then assessed for cytotoxicity on human lymphocytes. Results: Six of the tetrahydroisoquinolines showed broad spectrum bacteriostatic activity. The zones of inhibition produced ranged from 7 to 23 mm for 200 mg per disc. The presence of a lipophilic substituent at the para position of the pendant phenyl group conferred the highest antibacterial activity. Compound 2 [1-(3,4-chlorophenyl)-6- hydroxy-1,2,3,4-tetrahydroisoquinoline] was the most active and produced zones ranging from 9 to 20 mm against all eight bacterial strains. Compound 2 also showed the lowest minimum inhibitory concentration of 100 μg/mL against Escherichia coli ATCC11775 and the lowest minimum bactericidal concentration of 800 μg/mL against pathogenic Salmonella typhimurium. Overall, compound 2 was the most active with bacteriostatic and bactericidal activity against three and four bacterial strains respectively. A 50% cytotoxic concentration of 98.2 μg/mL was recorded for compound 2 indicating a low risk of toxicity. Conclusions: The 1-aryl-1,2,3,4-tetrahydroisoquinolines display structure-related antibacterial activity and further chemical exploration of the tetrahydroisoquinoline scaffold may yield more potent non-toxic derivatives for development into new antibacterials.
    10  The effect of renal stones on serum adenosine aminohydrolase and AMP-aminohydrolase in Malaysia
    Faridah Yusof Atheer Awad Mehde Wesen Adel Mehdi Hamid Ghazali Azlina Abd Rahman
    2015(6):478-484. DOI: 10.1016/j.apjtb.2015.04.003
    [Abstract](28) [HTML](0) [PDF 0.00 Byte](0)
    Abstract:
    Objective: To verify possible associations between adenosine aminohydrolase (ADA) and AMP-aminohydrolase (AMPDA) to E3 SUMO-protein ligase NSE2 (NSMCE2) in patients with renal stones. And to isolate, purify and characterize ADA in patients with renal stones and healthy group. Methods: A total of 60 renal stones patients and 50 control were enrolled in a case– control study. The blood urea, creatinine, uric acid, protein, albumin, ADA and AMPDA were measured by colorimetric tests. The serum NSMCE2 was measured by ELISA. Results: Serum ADA, AMPDA and specific activity of enzymes showed significant decrease (P < 0.05) in patients with renal stones compared to control group, mean levels of sera NSMCE2 and uric acid had a significant increase (P < 0.01 and P < 0.05, respectively) in patients compared to control group. Conclusions: The present study suggests that ADA, AMP deaminase and NSMCE2 can be used as a indicator to monitor the DNA damage and inflammation disorders in the patients with kidney stones.
    11  Biofilm formation in trimethoprim/sulfamethoxazole-susceptible and trimethoprim/ sulfamethoxazole-resistant uropathogenic Escherichia coli
    Nitis Smanthong Ratree Tavichakorntrakool Phitsamai Saisud Vitoon Prasongwatana Pipat Sribenjalux Aroonlug Lulitanond Orathai Tunkamnerdthai Chaisiri Wongkham Patcharee Boonsiri
    2015(6):485-487. DOI: 10.1016/j.apjtb.2015.03.006
    [Abstract](18) [HTML](0) [PDF 0.00 Byte](0)
    Abstract:
    Objective: To compare biofilm formation in trimethoprim/sulfamethoxazole (SXT)- susceptible Escherichia coli (E. coli) (SSEC) and SXT-resistant E. coli (SREC) isolated from patients with urinary tract infections, and study the motile ability and physical characteristics of the isolates. Methods: A total of 74 E. coli isolates were tested for antimicrobial susceptibility with the disc diffusion assay. Based on the SXT-susceptibility test, the E. coli isolates were divided into SSEC (N = 30) and SREC (N = 44) groups. All E. coli isolates were examined for motile ability by using a motility test medium, and for checking biofilm formation a scanning electron microscope was used. Bacterial colony size was measured with a vernier caliper and bacterial cell length was measured under a light microscope. The bacterial growth rate was studied by plotting the cell growth (absorbance) versus the incubation time. Results: The frequencies of non-motility and biofilm formation in the SREC group were significantly higher than that in the SSEC group (P < 0.01). The SREC bacterial cell length was shorter than that in the SSEC group [(1.35 ± 0.05) vs. (1.53 ± 0.05) μm, P < 0.05)], whereas the bacterial colony size and mid-log phase of the growth curve were not significantly different. Conclusions: The present study indicated that biofilm formation and phenotypic change of uropathogenic E. coli can be attributed to the mechanism of E. coli SXT resistance.
    12  Effect of pre-existing Schistosoma haematobium infection on Plasmodium berghei multiplications in imprinting control region mice
    Benjamin Amoani Elvis Ofori Ameyaw Du-Bois Asante Francis Ackah Armah James Prah Collins Paa Kwesi Botchey Johnson Nyarko Boampong
    2015(6):488-492. DOI: 10.1016/j.apjtb.2015.03.007
    [Abstract](27) [HTML](0) [PDF 0.00 Byte](0)
    Abstract:
    Objective: To investigate the effect of pre-existing Schistosoma haematobium (S. haematobium) infection on malaria disease severity. Methods: The study involved the use of twenty-five imprinting control region mice, fifteen of which were initially infected with S. haematobium. Five of the remaining ten schisto-uninfected mice together with five schisto-infected mice were infected with Plasmodium berghei (P. berghei) after four weeks (acute stage) of schistosoma infection. The remaining five schisto-uninfected mice together with five schisto-infected mice were also infected with P. berghei after seven weeks (chronic stage) of schistosoma infection. The last five schisto-infected mice were used as control group. They were then monitored for changes in P. berghei parasitaemia on Days 3, 5, 7, 9 and 11 post-infection. Records on their survivability were also taken. Results: The co-infected mice had significantly higher malaria parasitaemia, compared with the mono-infected mice during acute S. haematobium infection. In contrast, the co-infected mice had significantly lower malaria parasitaemia during chronic S. haematobium infection and a higher survival rate. Conclusions: Co-infection of mice with P. berghei during acute S. haematobium infection resulted in rapid P. berghei development and increased malaria parasitaemia. However, the co-infection resulted in slower P. berghei development and decreased malaria parasitaemia with enhanced survivability of the mice during chronic S. haematobium infection. Therefore, pre-existing chronic S. haematobium infection may provide some protection to the host by reducing parasitaemia.
    13  Morphology and viability of adult Fasciola gigantica (giant liver flukes) from Philippine carabaos (Bubalus bubalis) upon in vitro exposure to lead
    Aimee Caye G. Chang Mary Jane C. Flores
    2015(6):493-496. DOI: 10.1016/j.apjtb.2015.03.008
    [Abstract](23) [HTML](0) [PDF 526.28 K](76)
    Abstract:
    Objective: To evaluate the effects of lead in the morphology and viability of Fasciola gigantica (F. gigantica) (giant liver fluke) isolated from infected livers of carabaos in vitro using the following concentrations of lead: 0, 100, 150 and 200 mg/L. Methods: In vitro viability and motility assay was conducted to evaluate the effects of lead using 1% methylene blue as the vital dye for assessment of the flukes' viability. Results: Results indicate that F. gigantica can tolerate lead exposure as high as 200 mg/ L with visible morphological variations. Upon exposure to lead, liver flukes tend to curl and excrete black precipitates as a sign of physiological stress response. Furthermore, the lethal concentration (LC50) of lead against F. gigantica in vitro was 160 mg/L. Conclusions: In conclusion, tolerance of liver flukes to high levels of lead suggests its potential as a possible biomarker of environmental pollution.
    14  Evaluating patients' perception of service quality at hospitals in nine Chinese cities by use of the ServQual scale
    Min Li Douglas Bruce Lowrie Cheng-Yu Huang Xiang-Chan Lu Ying-Chu Zhu Xing-Hua Wu Mayila Shayiti Qiong-Zhen Tan Hua-Ling Yang Si-Yuan Chen Pan Zhao Sheng-Hua He Xiu-Rong Wang Hong-Zhou Lu
    2015(6):497-504. DOI: 10.1016/j.apjtb.2015.02.003
    [Abstract](21) [HTML](0) [PDF 522.14 K](86)
    Abstract:
    Objective: To investigate patients' perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQual scale method was used in a survey involving patients at outpatient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, productmoment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach's α for the reliability analysis was 0.978. All the Pearson correlation coefficients were positive and statistically significant. Visitors to out-patient facilities reported more positive perception than visitors to in-patient facilities on tangibles (t = 4.168, P < 0.001) and reliability (t = 1.979, P < 0.05). Patients of 60 years of age and above reported more positive perception than those between 40 and 49 on reliability (F = 3.311, P = 0.010), assurances (F = 2.751, P < 0.05) and empathy (F = 4.009, P = 0.003). For the five dimensions of the scale, patients in Laibin, Guangxi reported the most positive perceived service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coefficients showed statistically significant (P < 0.001) positive values for all ServQual dimensions. Empathy (β = 0.267) and reliability (β = 0.239) most strongly predicted perception of service quality. Conclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.
    15  Epidemiology of extra pulmonary tuberculosis in Eastern Sudan
    Taj Eldin Mohammedein Abdallah Fatah Elrahman Mohmmed Toum Osman Habeeb Bashir Tajedin Ibrahim Mansoor Mona Mamoun Yuosif Mustafa Awad-Elseed Elkhawad Idris Osman Okud Abbashar Osman Mohammed Abdel Aziem Abdalla Ali
    2015(6):505-508. DOI: 10.1016/j.apjtb.2015.02.004
    [Abstract](20) [HTML](0) [PDF 455.54 K](84)
    Abstract:
    Objective: To investigate the epidemiological factors associated with extra pulmonary tuberculosis (EPTB) in Kassala, Eastern Sudan. Methods: Patients infected with TB (pulmonary and extra-pulmonary) documented at the hospital were interviewed with a structured questionnaire used to gather sociodemographic information. The diagnosis of EPTB cases was based on presence of tuberculous granulomas in the histological samples, positive PCR to DNA of mycobacterium tuberculosis, radiological findings and fluid analysis suggestive of EPTB and clinical diagnosis with adequate response to anti-tuberculous therapy. Results: A total of 985 patients with TB were enrolled in the study, including 761 (77.3%) with PTB and 224 (22.7%) with EPTB. The mean age (SD) of patients with PTB and EPTB was 33.2 (15.4) and 34.7 (14.6) years respectively. The prevalence of EPTB was at (22.7%), with TB lymphadenitis 79 (35.3%), marking the frequent form of EPTB followed by peritoneal TB 27 (12.05%). While residence and occupation were not associated with EPTB, those with lower level of education (OR = 0.3; confidence intervals (CI) = 0.2–0.5; P < 0.001), female (OR = 8.7, CI = 4.9–15.1, P < 0.001), non vaccination (OR = 70.3, CI = 34.2–144.3, P < 0.001), and non smoker (OR = 0.1; CI = 0.06–0.20; P < 0.001), were associated with high prevalence of EPTB. Conclusions: Around one quarter of patients with TB in this study were more likely to have EPTB. Therefore, effective strategic plans regarding diagnostic procedures and control measures are needed to reduce the burden of the disease in Sudan.

    Current Issue


    Volume , No.

    Table of Contents Archive

    Volume

    Issue

    Most Read

    Most Cited

    Most Downloaded

    Academic misconduct statement

      Peer review

      WeChat

      Mobile website

      Close