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Pathophysiology of pre-eclampsia depends on a defective trophoblastic invasion of uteroplacental blood vessels that leads to placental ischemia and induction of an inflammatory process within the placenta. This process may trigger the expression of Cancer antigen 125 (CA 125), C-reactive protein (CRP) and uric acid (UA). This research aimed to evaluate the association of serum CA 125, CRP and uric acid with Preeclampsia. The study recruited 200 singleton Sudanese pregnant women, who were divided into three groups: controls (n = 100), mild preeclampsia (n = 46) and severe preeclampsia (n = 54). The study subjects were matched for maternal age, gestational age and body mass index. Blood samples were taken for measurement of the different variables using immune- assay and enzymatic automated chemical analysis. The levels of CA 125 in mild and severe preeclampsia were (21.94±0.749 IU/ml) and (40.78±1.336 IU/ml) respectively, which was significantly different (P<0.001) from the control mean (16.48±0.584 IU/ml). There was also a significant difference between the mean levels of CRP in mild and severe preeclampsia (15.17±0.788 mg/L), (31.50±1.709 mg/L) compared with controls (4.79±0.178 mg/L), (P<0.01). There was also a significant difference in the mean levels of UA in mild and severe cases (6.44±0.293 and7.37±0.272) in comparison with the controls (4.00±0.061); (P<0.001). There were significant differences between severe and mild groups (P<0.05). Cancer antigen 125, CRP and UA levels‎ correlated positively with mean arterial blood pressure (MAP) where (r >0.7; P < 0.001). ROC curve validates the utility of these biomarkers for monitoring preeclampsia (AUC >0.8; P < 0.001). In conclusion CA 125, CRP and UA were significantly higher in preeclampsia compared with the controls. The rise of the analytes was directly associated with the severity of the disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Suliman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Essential hypertension (EH) is a disease caused by various environmental and genetic factors. Nitric oxide (NO) is important for the functional integrity of the endothelium. It is produced in endothelial cells by endothelial NO synthase (eNOS) that mediates the conversion of the amino acid arginine into NO and citrulline. Asymmetric dimethylarginine (ADMA) acts as an inhibitor of eNOS. In contrast, symmetric dimethylarginine (SDMA) has no direct effect on eNOS but plays an important role competing with arginine for transport across the amino acid transporter. ADMA and SDMA have been found to play a central role in the development of cardiovascular diseases. Serum ADMA levels may serve as a future diagnostic marker and a target of therapy in hypertensive patients in the Sudanese population. This study aimed to investigate the relation between serum arginine, ADMA, and SDMA levels with EH in the Sudanese population., Methods: Patients (n = 260) with established hypertension and controls (n = 144) with normal blood pressure were included in this case-control study. Serum blood samples were analyzed for arginine, ADMA, and SDMA, using high-performance liquid chromatography-tandem mass spectrometry. Other laboratory data were measured using routine methods. Mann-Whitney's U test and χ2 tests were used for continuous and categorical data, respectively. A multivariate logistic regression analysis was conducted to investigate the independent effect of multiple variables on the development of hypertension., Results: Serum arginine levels were significantly lower in the patient group than in the control group (p < 0.001). ADMA and SDMA levels were significantly higher in the patient group than the control group (p < 0.001, p = 0.001, respectively). Multivariate logistic regression analysis showed that only older age, being a male, and arginine levels are independent factors controlling the development of hypertension (p < 0.001, p < 0.001, and p = 0.046, respectively). ADMA and SDMA levels were not independent factors for the development of hypertension., Conclusions: This study demonstrated increased serum levels of ADMA and SDMA and decreased arginine levels in Sudanese patients with EH. Lowering serum ADMA levels or increasing the arginine levels might be a novel therapeutic target in these individuals., (© 2020 The Author(s) Published by S. Karger AG, Basel.)

Background: Vitiligo is the most common pigmentary skin disorder. It is a multifactorial polygenic disease with epidermal melanocyte destruction. The cytokines profile found in vitiliginous patients was not fully elucidated., Aims: We sought to assess the autoimmune nature of vitiligo by comparing plasma levels of interleukin (IL)-17, IL-23, and transforming growth factor beta (TGF-β) in adult Sudanese vitiligo patients with matched control individuals., Subjects and Methods: Case-control study was conducted in Khartoum Dermatologic Teaching Hospital, in the period between July and December 2013. The cases were 42 adult Sudanese vitiligo patients matched with 43 control individuals. The cytokines were measured in the plasma by the quantitative "sandwich" ELISA., Results: Patients showed a significant lower median (25-75(th) inter-quartile) of TGF-β than control (0.042 [0.041-0.044] vs. 0.047 [0.042-0.049]; P ≤ 0.001). Both IL-17 and IL-23 showed no significant difference between cases and controls. IL-17 showed a significant inverse relationship when correlated with TGF-β (r = -0.24; P = 0.026) while showing direct relationship when correlated with age (r = 0.28; P = 0.009)., Conclusion: The positive findings detected in this study coincide with the important immunoregulatory role of the TGF-β, and support the autoimmune nature of the disease.

Anaemia is a widespread problem in many parts of the world especially in tropic areas. Among pregnant women, it has negative consequences on maternal and perinatal outcomes. A cross-sectional study was conducted to investigate the prevalence of anaemia, iron, zinc and copper deficiencies among pregnant women in Wad Medani hospital, central Sudan and to examine the relationship of these micronutrients with haemoglobin (Hb) levels. One hundred four (52.5%) out of 200 pregnant women had anaemia (Hb < 11 gm/dl) and 3 (1.5) % had severe anaemia (Hb < 7 gm/dl). Iron deficiency (S-ferritin < 15 µg/l), iron deficiency anaemia (<11 gm/dl and S-ferritin < 15 µg/l) were prevalent in 25 (12.5%) and 13 (6.5%) of these women, respectively. Ninety (45.0%) and eight (4.0%) of these women had zinc (<80 µg/ml) and copper (<80 µg/ml) deficiency, respectively. In 24 (12.0%) of these women, there were ≥2 deficiencies of these elements. S-copper was not [corrected] significantly lower in patients with anaemia. While age, parity, gestational age, ferritin, zinc and copper were not predictors for anaemia, women who practiced pica were at higher risk for anaemia (OR = 3.4, 95% CI = 1.4-7.9, P = 0.004). Gestational age was significantly inversely correlated with haemoglobin (r = 0.161, P = 0.03), S-ferritin (r = 0.285, P = 0.001) and S-zinc (r = 0.166, P = 0.02). Thus, dietary and supplement interventions are required to prevent and control anaemia in this setting. Further research is needed.

This case-control study was conducted in Khartoum hospital, Sudan to investigate the levels of antioxidant enzymes (glutathione peroxidase, catalase and superoxide dismutase) in erythrocytes and plasma antioxidant vitamins (retinol and alpha-tocopherol) in Sudanese women with pre-eclampsia (37), in comparison with well-matched pregnant controls women with normal pregnancy (38). Enzymes were measured using ELISA and vitamins were measured using HPLC. There were no significant differences in the levels of these three antioxidant enzymes in pre-eclamptic women compared with the controls. Women with mild pre-eclampsia (diastolic blood pressure, DBP < 110) have slightly higher levels of erythrocyte glutathione peroxidase, and lower levels of catalase and superoxide dismutase compared with women with severe pre-eclampsia (DBP > or = 110). A significantly negative correlation was observed between the levels of glutathione peroxidase and DBP, r = -0.371, p = 0.02. There was no significant correlation between catalase (r = -0.033, p = 0.840) or superoxide dismutase levels (r = 0.067, p = 0.6) and DBP. While retinol levels were not different, levels of alpha-tocopherol were significantly higher in women with pre-eclampsia than the control group, p = 0.026. The plasma levels of both vitamins were not statistically significantly different when women with mild and severe pre-eclampsia were compared.

A case-control study was conducted in Khartoum hospital, Sudan to compare omega-3 and omega-6 fatty acids profile in three phospholipid fractions (phosphatidylethanolamine, phosphatidylcholine and sphingomyelin) using gas chromatography in erythrocytes from 65 pre-eclamptic women and well-matched 60 healthy control pregnant women, both in the third trimester of pregnancy. While levels of arachidonic acid (omega-6 fatty acid) was significantly higher in women with pre-eclampsia in the sphingomyelin fraction only, the levels of eicosapentaenoic and docosahexaenoic acid (omega-3 fatty acid) in the three phospholipids fractions were significantly higher in women with pre-eclampsia than in the control group. Both omega-3 and omega-6 fatty acids profiles were not significantly different between patients with mild (diastolic blood pressure (DBP) <110 mmHg) and severe (DBP > or = 110 mmHg) pre-eclampsia.

This study aimed to investigate the incidence of eclampsia and its maternal and perinatal outcome in the Hospital of Obstetrics and Gynecology at Gadarif, Sudan from March 2007 to April 2009. There were 45 cases of eclampsia in 8,894 deliveries (5/1,000). Some 62% of first convulsions occurred antepartum, 15.5% occurred intrapartum, and the rest (11.1%) occurred postpartum. Ten patients died and there were 16 (35.5%) perinatal deaths; eight of these were stillbirths and eight were early neonatal deaths.

Background: Cytokine imbalance in preeclampsia may be one of the etiological factors for preeclampsia., Objectives: The study was conducted to investigate interferon gamma (IFN-gamma), interleukin-4 (IL-4) and interleukin-10 (IL-10) in preeclampsia. Enzyme-linked immunosorbent assay (ELISA) was used to measure the concentrations of these three pro-inflammatory cytokines in sera from 33 Sudanese women with preeclampsia (at presentation and 7 days later) and 32 women with normal pregnancy as a control group., Results: The levels of IFN-gamma and IL-4 were slightly--not statistically significant--higher in the women with preeclampsia. IL-10 was significantly higher in the women with preeclampsia. Women with preeclampsia had significantly lower levels of IFN-gamma and IL-4 and significantly higher levels of IL-10 7 days later in comparison with the presenting levels., Conclusion: Thus, the significantly raised levels of IL-10 in women with preeclampsia suggest its role in pathogenesis of preeclampsia, and further research is needed.

Background: Cesarean section delivery can lead to much maternal morbidity. Different cytokines have been reported to be influenced by the mode of delivery., Objective: To investigate the influence of mode of delivery on maternal, placental and cord sera of interferon gamma (IFN-gamma), interleukin-4 (IL-4) and interleukin-10 (IL-10) levels., Methods: These three cytokines were measured using ELISA in peripheral, placental and cord sera of two groups of women (38 in each group), either delivering vaginally or by elective cesarean section., Results: Concentrations of IFN-gamma, IL-4 and IL-10 in the peripheral and placental sera were higher in vaginal delivery, while cord cytokines were not significantly different in the two groups. Cord sera contained significantly less concentrations of these cytokines than the peripheral and placental sera., Conclusion: It appears that the levels of IFN-gamma, IL-4 and IL-10 are influenced by the mode of delivery.