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Critical disparities threaten health care in developing countries and hinder progress towards global development commitments. Almost a billion people and thousands of public services are not yet connected to electricity – a majority in sub-Saharan Africa. In economically fragile settings, clinics and health services struggle to gain and maintain their access to the most basic energy infrastructure. Less than 30% of health facilities in LMICs report access to reliable energy sources, truncating health outcomes and endangering patients in critical conditions. While ‘universal health coverage’ and ‘sustainable energy for all’ are two distinct SDGs with their respective targets, this review challenges their disconnect and inspects their interdependence in LMICs. To evaluate the impact of electrification on healthcare facilities in LMICs, this systematic review analysed relevant publications up to March 2021, using MEDLINE, Embase, Scopus, CENTRAL, clinicaltrials.gov and CINAHL. Outcomes captured were in accordance with the WHO HHFA modules. A total of 5083 studies were identified, 12 fulfilled the inclusion criteria of this review – most were from Africa, with the exception of two studies from India and one from Fiji. Electrification was associated with improvements in the quality of antenatal care services, vaccination rates, emergency capabilities and primary health services; with many facilities reporting high-quality, reliable and continuous oxygen supplies, refrigeration and enhanced medical supply chains. Renewable energy sources were considered in six of the included studies, most highlighting their suitability for rural health facilities. Notably, solar-powered oxygen delivery systems reduced childhood mortality and length of hospital stay. Unavailable and unreliable electricity is a bottleneck to health service delivery in LMICs. Electrification was associated with increased service availability, readiness and quality of care – especially for women, children and those under critical care. This study indicates that stable and clean electrification allows new heights in achieving SDG 3 and SDG7 in LMICs.

The Fall armyworm worm (FAW) (Spodopterafrugiperda) is one of the important economic pests which goes on several field crops and causes serious damage. The aim of this study was to look for efficient, less cost and environmentally friend plant extract for controlling Fall armyworm worm in cereal crops. A Complete Randomized Block Design (CRBD) experiments with three replications were conducted in the laboratory to investigate the insecticidal effects of four plant extracts consisting of ethanolic extract of Neem (Azadirachta indica) seeds, Black pepper (Piper nigrum) seeds, Usher (Calotropis procera ) leaves and water extracts of Argel (Solenostemma argel) leaves on larvae of the Fall armyworm (FAW) (Spodoptera frugiperda). Newly emerged larvae of FAW were treated topically by 4 concentrations (10, 25, 50 and 75%) of each extract, and then the larval mortalities were calculated after 24, 48 and72 hrs. The results showed the highest concentrations (75%) of the three ethanolic extracts gave higher mortality percentages (100%) after 72 hrs of exposure, compared with other concentrations. Also, these were not significantly different from the recommended dose of the standard pesticide “Spinosad”. On the other hand, Argel water extract showed no effect on the (FAW) larvae. It is recommended that this experiment to be replicated under different environments.

This paper attempts to achieve two core objectives. Firstly, it aims to synthesize the information contained in the different expenditure components of GDP for developing a set of Autoregressive Moving-Average (ARMA) models to examine the effect of shocks on the current and subsequent cyclical deviations of Sudan real GDP from what is trending. Secondly, it aims to compare the intensity of those cyclical deviations within the reviewed period (1970-2010) and outside it. ARMA models of different orders are experimented to distinguish, empirically, whether the effect of shocks is transient or permanent and lasts for a long period of time. The major result is that the lingering effect of shocks is permanent causing intensified deviation from the trend outside the reviewed period.

Background: Extended spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) constitute an emerging public-health concern. Consider that ESBL genes type CTX-M types has been increased significantly in most parts of the world. Few data are available on the CTX-M variants circulating in Sudan. Objective: This study used polymerase chain reaction (PCR) and bioinformatics tools to identify blaCTX-M and its variants for Extended-spectrum β-lactamase (ESBLs) producing clinical isolates of Escherichia coli (E. coli) obtained from hospitals in Khartoum-Sudan. Methods: A total of 216 non-repetitive isolates were selected during 2007-2018. The phenotypic identification of ESBL production was confirmed according to CLSI guidelines. CTX-M genotype was analyzed by uniplex PCRs reactions subsequently sequences performed later sequences were analyzed using bioinformatics tools with nBLAST program, multiple alignments to determine CTX-M genotype variants . Nucleotide sequences were submitted to Gen Bank and accession numbers were obtained. Result: ESBL phenotype among 212 confirmed E.coli isolates was (34.9% of 212,n=74). (62.2% of 74, n=46) strains carried bla CTX-M genes, CTX-M genotype variants identified in this study as followed: blaCTX-M-15 gene was the most prevalent one (78.6%) followed by blaCTX 90 (14.3%) and CTX-M55 (7.1%), Conclusion: This study reveled high ESBL occurrence among E.coli isolates, with CTX-M 15 the predominant variants and highlights the incidence of CTX-M-55 for the first time from Sudan. Keywords: E. coli, PCR, ESBLs, CTX-M, Sudan, bioinformatics

OBJECTIVE: Women with Turner's syndrome (TS) have recently been shown to be at an increased risk of developing chronic liver disease. There has been some concern that oestrogen replacement therapy may exacerbate hepatic dysfunction. The aim of this study was to assess hepatic function in women with TS and to determine the effect of oral oestradiol valerate on liver enzymes. DESIGN AND PATIENTS: A retrospective review of liver enzymes of 80 women with TS, followed by a prospective study looking at serum liver enzyme concentrations in 20 women with TS following 3 months on and off hormone replacement therapy (HRT) (oestradiol valerate, 2 mg/levonorgestril 75 microg). MEASUREMENTS: Liver enzymes (gamma glutamyl transferase, aspartate transaminase and alkaline phosphatase), albumin and bilirubin were measured on and off HRT. Viral hepatitis serology and liver autoantibodies were tested in patients with abnormal liver function. RESULTS: Thirty-five out of 80 women (44%) had elevated serum liver enzyme concentrations. Two women (2.5%) had a mildly raised serum bilirubin, but protein synthesis was normal in all subjects. HRT resulted in a significant fall in all liver enzymes (P < 0.05) but did not affect serum protein concentrations CONCLUSIONS: Women with Turner's syndrome often have elevated liver enzymes. Oestrogen/progestagen therapy using oestradiol valerate improves liver function in this group of patients. The mechanisms behind this are unclear.

OBJECTIVE: Females with Turner's syndrome (TS) are at an increased risk of developing autoimmune thyroid disease. Studies assessing the influence of karyotype on thyroid autoimmunity in adults with TS have yielded conflicting results but have been limited by small numbers. The aim of this study was to determine the frequency of thyroid autoimmunity in a large cohort of women with TS and to assess the influence of karyotype on the development of thyroid disease. DESIGN, PATIENTS AND MEASUREMENTS: Data were available for 145 women with TS attending a dedicated adult Turner clinic. The mean age was 26 years (range 16-52 years). Information regarding the presence of thyroid disease, karyotype, thyroid autoantibodies and thyroid function was recorded in all. The chi-squared test with Yates' correction was used to assess the association between karyotype and thyroid autoimmunity. RESULTS: Forty-one per cent of women with TS had positive thyroid autoantibodies and 16% of women were hypothyroid on replacement therapy with thyroxine. However, 83% of women with an X-isochromosome had positive thyroid autoantibodies compared with 33% of women with other karyotypes (P < 0.0001). Women with an isochromosome-X karyotype were also significantly more likely to become frankly hypothyroid and require thyroxine compared with other karyotypes (37.5% isochromosome-X vs. 14% 45, X vs. 6% other karyotypes P = 0.0034). CONCLUSIONS: In this large cohort of women with TS we have shown that the risk of developing autoimmune thyroid disease is particularly high in women with an X-isochromosome, suggesting that a gene on the long arm of the X chromosome (Xq) may play an important pathogenetic role in the development of autoimmune thyroid disease.

Preconceptual folic acid use is known to have a protective effect against neural tube defects (NTDs). This study assessed knowledge and determinants of awareness on folic acid use among pregnant women at Omdurman Maternity Hospital, Sudan during 2014. The standardized, anonymous questionnaire was used to collect data. Almost 80% of respondents had heard of folic acid. College-educated women (92.2%) knew more about folic acid and used it more often in the pre-conceptual period (8.3%). Doctors were the commonest source of information on folic acid (62%). Fewer subjects (8.9%) knew that it prevented birth defects, and 33.8% of subjects knew that green leafy vegetables are a source of folic acid. Of all subjects, only 3.2% use it preconceptually. Supplementation of folic acid preconceptually needs to be addressed in order to reduce the rate of NTDs found in Sudan.معلومات ومحددات تناول حمض الفوليك بين النساء الحوامل في أم درمان، السودان.محمد الخاتم السمانى، عبد الإله كنه، الشيخ محمد آدم.من المعروف أن استخدام حمض الفوليك قبل الحمل له أثر وقائي ضد عيوب الأنبوب العصبي. وقد عمدت هذه الدراسة إلى تقييم معلومات ومحددات الوعي باستخدام حمض الفوليك في صفوف النساء الحوامل في مستشفى الولادة بأم درمان في السودان خال عام 2014. واستُخدم استبيان موحد مجهّل الأساء من أجل جمع البيانات. وتبن أن نحو 80 % من المستجيبات قد سمعن عن حمض الفوليك من قبل. وسجلت النساء الجامعيات (92.2 %) معرفة أعى بحمض الفوليك كا استخدمنه أكثر من غيرهن في مرحلة ما قبل الحمل (8.3 %). وشكل الأطباء أكثر المصادر شيوعا للمعلومات المتعلقة بحمض الفوليك (62 %). وتبن أن عدد أقل من أفراد الدراسة (8.9 %) كن عى معرفة بأن حمض الفوليك يحول دون حدوث عيوب ولادية، وأن 33.8 % المشاركات كن عى معرفة بأن الخروات الورقية تمثل مصدراً من مصادر حمض الفوليك. وأن 3.2 % فقط تستخدمنه في مرحلة ما قبل الحمل. وارتبط مستوى الوعي بالعيش في المناطق الحضرية، وارتفاع مستوى التعليم، والحصول عى رعاية ما قبل الولادة (0.05P). ويجب النظر في استخدام مكمات حمض الفوليك في مرحلة ما قبل الولادة من أجل خفض معدل الإصابة بعيوب الأنبوب العصبي في السودان.Facteurs associés aux connaissances et déterminants concernant l’apport en acide folique parmi les femmes en âge de procréer au Soudan.La consommation d’acide folique avant la conception est connue pour avoir un effet protecteur contre les anomalies du tube neural (ATD). La présente étude avait pour objectif d’évaluer les connaissances et déterminants de la sensibilisation à la consommation d’acide folique parmi les femmes enceintes à la maternité de l’hôpital d’Omdourman au Soudan en 2014. Un questionnaire, standardisé et anonyme, a été utilisé pour collecter des données. Près de 80 % des répondants avaient déjà entendu parler de l’acide folique. Les femmes ayant reçu une éducation universitaire (92,2 %) en savaient plus sur l’acide folique et en consommaient davantage souvent durant la période préconceptionnelle (8,3 %). Les médecins étaient la source d’information la plus courante sur l’acide folique (62 %). Un nombre inférieur de sujets (8,9 %) étaient conscients que l’acide folique permet de prévenir les malformations congénitales et 33,8 % des sujets savaient que les légumes vert à feuilles constituent une source d’acide folique. Parmi tous les sujets, seulement 3,2 % en consommaient avant la conception. La supplémentation préconceptionnelle en acide folique doit être prise en compte afin de réduire la forte incidence des ATD constatées au Soudan.