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Abstract Background The UN General Assembly recognised the human right to water and sanitation through the sixth SDG in 2010. South Kordofan, a state in southern Sudan, faces WASH challenges due to conflict, geographical factors, and inadequate services, impacting over 600,000 residents. Such conflicts are well known for spreading diseases and disrupting WASH-related practices among displaced individuals. Objectives The study aimed to evaluate the quality and availability of drinking water, as well as sanitation and hygiene practices in rural South Kordofan. It also sought to identify factors affecting community satisfaction with WASH services and to establish a data-driven basis for future interventions addressing these issues. Methods A cross-sectional study accompanied a medical mission to South Kordofan, selecting 33 villages from South Kordofan based on healthcare, population, and accessibility. Water samples, patient forms and questionnaires were collected using convenient sampling for targeted villages and for attendants of mobile clinics. Laboratory analyses were conducted on water samples. Descriptive statistics, univariate analysis and logistic regression were used to analyse the data. The used level of significance was 0.05. Results Out of 784 participants, 60.2% were female. Tube wells/boreholes were the primary water source (68.1%), and most participants (70.9%) lived near their water source (less than 30 min). Dissatisfaction with water services was reported by 56.8%, and satisfaction associated with method of delivery (OR = 0.081, CI = 0.024–0.276)), appearance (OR = 0.299, CI = 0.182–0.489), distance (OR = 0.264, CI = 0.099–0.705), water unavailability (OR = 0.477, CI = 0.297–0.765), and obligation to pay (OR = 0.351, CI = 0.185–0.665). Samples showed high levels of contamination, both microbial and physicochemical. Regarding sanitation, over a third of the participants (41.5%) disposed of children’s stool by leaving it outdoors. About 10% of the participants reported having diarrhea during the week before the study. However, about two-thirds of the participants (68.1%) showed good hygienic practices by using soap or detergents for hand washing. Conclusion The study revealed inadequate WASH services, high microbial contamination, and poor water treatment practices. Paradoxically, many participants expressed satisfaction with water services. Sanitation issues and open defecation persist, emphasizing the need for comprehensive interventions. All these negative consequences can be attributed to the armed conflict which resulted in poor awareness about the safety of drinking water, what safe water looks like and proper hygiene practices. Moreover, these conflicts led to disruption of the economical status leading to the absence of proper water purification infrastructure.

Abstract Background The WHO defines mental health as well-being where individuals manage stress, work productively, and contribute to their community. Children’s mental health is critical, especially among vulnerable groups like refugees. Research shows refugee children, including Sudanese, face PTSD, depression, and anxiety due to conflict and displacement, yet specific studies on Sudanese children are scarce. East Africa faces high prevalence due to poverty, conflict, and inadequate healthcare. Sudan’s situation is exacerbated by ongoing conflict and limited resources, despite efforts from NGOs and international organizations. Methodology This cross-sectional descriptive study examines the mental health of Sudanese school-age children (6–18 years) in Ad-Damar, River Nile, Sudan, using a simple random sampling technique. The study included 246 participants. Data were collected using an author-designed questionnaire based on the Strengths and Difficulties Questionnaire (SDQ), supplemented with demographic information. Data management involved secure handling and ethical considerations, including informed consent and confidentiality. Statistical analysis was performed using SPSS V.25 to ensure accuracy and reliability of the findings. Results The sample included children aged 6–18 years, with 54% males and 46% females. Displacement duration varied, with 34% displaced for 1–2 years. Socio-demographic findings indicated 39% lived with both parents, 56% were in urban environments, and 47% were in primary school. Mental health assessments revealed 68% frequently felt sad, 73% felt anxious, and 29% had diagnosed conditions, including PTSD and depression. Correlations showed significant positive relationships between overall mood ratings and both school support (r = 0.45, p

Background: The coronavirus disease 2019 (COVID-19) effect on the lungs ranges from an asymptomatic infection to a critical illness with acute respiratory failure, acute respiratory distress syndrome (ARDS), septic shock, or multiorgan failure. Pulmonary fibrosis, as a short-term or long-term complication of SARS-CoV-2 infection, is a progressive and fatal sequel to COVID-19. The present study assessed the risk factors and clinical findings associated with post-COVID-19 pulmonary fibrosis. Methods and Results: This case-control study was conducted among Omani citizens and residents of Sohar State, Oman, from 01 Jan 2020 to 31 Dec 2022. The study involved 106 patients with post-COVID-19 pulmonary fibrosis (the main group) and 102 subjects who recovered from COVID-19 without pulmonary fibrosis (the control group). Advanced age, length of hospital stay, and the need for mechanical ventilation were significantly associated with post-COVID-19 pulmonary fibrosis. Moreover, the current study reported a significant elevation in total white blood cell count, serum lactate dehydrogenase, serum creatinine, and D-dimer levels among patients with pulmonary fibrosis. Conclusion: The current study demonstrated a potential association between post-COVID-19 pulmonary fibrosis and severity-associated markers of COVID-19.

Background: Induction of labor (IOL) initiates labor artificially, aiming to prevent potential risks for both mother and fetus. However, data on IOL outcomes for parous women in the developing countries are scarce. Objectives: This study evaluates maternal and neonatal outcomes in parous women undergoing IOL at a Sudanese hospital. Methods: A descriptive cross-sectional study included 75 parous women undergoing IOL at Haj-Alsafi Teaching Hospital. Demographic data, reasons for IOL, and maternal and neonatal outcomes were recorded. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) software, version 26, with P values < 0.05 considered statistically significant. Results: Of 600 women, 75 (12.5%) underwent IOL over 6 months. Main indications were hypertensive disorders (21.3%) and postterm pregnancy (17.3%). Successful vaginal delivery (88%) predominated, with 12% requiring instrumental delivery. Maternal complications included postpartum hemorrhage (8%) and ruptured uterus (1.3%), while 69.7% had no complications. The neonatal survival rate was 91%, with 30.7% admitted to the Neonatal Intensive Care Unit (NICU) for further care. Among the NICU admissions, the mortality rate was 17.4%, all were preterm neonates. Conclusion: IOL is associated with successful VD in 88% and low rate of complications among the parous women; however, greater efforts are needed to prevent serious outcomes among the neonates.

Abstract Background: Total hip arthroplasty (THA) by using ceramic-on-ceramic (CoC) implants has emerged as a promising solution to mitigate wear debris-related complications, such as osteolysis, specifically in younger patients. This study aims to investigate the functional outcomes after total hip replacement by CoC in patients less than 30 years old, conducted within the hospitals of Khartoum, Sudan. Methods: A descriptive, cross-sectional, hospital-based study was carried out across the major healthcare institutions in Khartoum state from October 2021 to April 2022. A cohort of 32 patients, all aged 30 or below, who underwent total hip replacement were included. Thorough data analysis was conducted using advanced statistical techniques. Results: The average age of included patients was 25.69 ± 2.7 years, among them, males had a slight predominance (56.3%) with a male-to-female ratio of 1.3:1. Most patients had a secondary school level of education (37.5%), while workers constituted the largest group (34.4%). The included patients were followed-up for more than six months. The mean visual analog scale (VAS) score was 7.91 ± 0.893. Additionally, the mean modified Harris hip score was 83.03 ± 4.9 (range: 72–91), highlighting the enhanced hip function achieved through the procedure. The majority of patients (65.6%) reported good functional outcomes, followed by 28.1% who attained fair outcomes and 25.8% who reported excellent outcomes. Conclusion: The study demonstrates that CoC THA yields optimal functional outcomes among patients aged 30 years and below. The procedure exhibits remarkable potential to improve hip function and alleviate pain in this specific patient population. These findings highlight the efficacy and viability of CoC implants in younger patients, contributing to the advancement of hip arthroplasty techniques.

Nanoscience and technology play an essential role in different various scientific fields domains as since it offers unique properties and diverse industrial applications. This study introduces an efficient method to synthesize silver nanoparticles (AgNPs) using Aristolochia bracteolate bud extract. The synthesized AgNPs are embedded within Poly (methyl methacrylate) (PMMA) to prepare a sustainable nanocomposite film (Ag-PMMA NC). Characterization techniques reveal the distinct properties of AgNPs and Ag-PMMA NC. Thermogravimetric analysis (TGA) shows enhanced heat stability of the polymer with Ag nano-filler. UV-vis spectroscopy detects a peak for AgNPs at 440 nm, with an average size of 180.4 nm and a polydispersity index (PDI) of 0.389, indicating uniform size. Fourier transform infrared spectroscopy (FTIR) of Ag-PMMA exhibits characteristic peaks between 300-700 cm-−1, confirming Ag-PMMA interactions. Both green-synthesized AgNPs and the resulting Ag-PMMA NC film demonstrate potent antibacterial activity against Gram-positive Bacillus cereus (∼15 mm) and Gram-negative Escherichia coli (∼26 mm), showing promise for water purification and other applications.

Taghrid S Alomar,1 Najla AlMasoud,1 Manal A Awad,2 Reem S AlOmar,3 Nada M Merghani,4 Mohamed El-Zaidy,5 Ajaya Bhattarai6 1Department of Chemistry, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, 11671, Saudi Arabia; 2King Abdullah Institute for Nanotechnology, King Saud University, Riyadh, 11451, Saudi Arabia; 3Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 32210, Saudi Arabia; 4Central Research Laboratory, Vice Rectorate for Studies and Scientific Research, King Saud University, Riyadh, 11451, Saudi Arabia; 5Department of Botany and Microbiology, Faculty of Science, King Saud University, Riyadh, 11459, Saudi Arabia; 6Department of Chemistry, Mahendra Morang Adarsh Multiple Campus, Tribhuvan University, Biratnagar, 56613, NepalCorrespondence: Ajaya Bhattarai; Manal A Awad, Email ajaya.bhattarai@mmamc.tu.edu.np; mawad@ksu.edu.saIntroduction: Researchers are increasingly favouring the use of biological resources in the synthesis of metallic nanoparticles. This synthesis process is quick and affordable. The current study examined the antibacterial and anticancer effects of silver nanoparticles (AgNPs) derived from the Neurada procumbens plant. Biomolecules derived from natural sources can be used to coat AgNPs to make them biocompatible.Methods: UV-Vis spectroscopy was used to verify the synthesis of AgNPs from Neurada procumbens plant extract, while transmission electron microscopy (TEM), photoluminescence (PL) spectroscopy, dynamic light scattering (DLS), and Fourier transform infrared spectroscopy (FTIR) were used to characterize their morphology, crystalline structure, stability, and coating.Results: UV-visible spectrum of AgNPs shows an absorption peak at 422 nm, indicating the isotropic nature of these nanoparticles. As a result of the emergence of a transmission peak at 804.53 and 615.95 cm− 1 in the spectrum of the infrared light emitted by atoms in a sample, FTIR spectroscopy demonstrated that the Ag stretching vibration mode is metal-oxygen (M-O). Electron dispersive X-ray (EDX) spectral analysis shows that elementary silver has a peak at 3 keV. Irradiating the silver surface with electrons, photons, or laser beams triggers the illumination. The emission peak locations have been found between 300 and 550 nm. As a result of DLS analysis, suspended particles showed a bimodal size distribution, with their Z-average particle size being 93.38 nm.Conclusion: The findings showed that the antibacterial action of AgNPs was substantially (p≤ 0.05) more evident against Gramme-positive strains (S. aureus and B. cereus) than E. coli. The biosynthesis of AgNPs is an environmentally friendly method for making nanostructures that have antimicrobial and anticancer properties.Keywords: Silver nanoparticles, UV-Vis spectroscopy, transmission peak, dynamic light scattering

The impact of learning enjoyment on motivation, enthusiasm, and overall learning experiences is significant. Previous studies, lacking an unbiased tool for measuring enjoyment and confronting various influencing factors, produced conflicting results regarding enjoyment levels in different instructional methods. Hence, we developed a learning enjoyment scale for evaluating both active and passive educational activities. We applied the developed scale to 112 first-year medical and dental students to assess their enjoyment during didactic physiology lectures and explored possible associated factors. Within this data note, we present students’ responses to the developed LES. The LES encompasses six dimensions: knowledge, comprehension, application, analysis, concentration, and enjoyment. Students provided ratings for each dimension on a five-point Likert scale, spanning from 1 (strongly disagree) to 5 (strongly agree). The cumulative scores across the six dimensions range from a minimum of 6 to a maximum of 30. These total scores can be categorized as excellent (> 24), acceptable (18-24), or low (< 18). The second section of the dataset examines specific factors influencing overall enjoyment, such as teacher proficiency, topic difficulty, active student participation, objectives fulfillment, low stress levels, and self-perceived acquisition of skills. In addition to objective measurement of students’ enjoyment level, the LES can be utilized for quantitative cross-comparisons between different teaching activities. By employing this dataset, we will undertake an analysis to determine the internal consistency of the Learning Enjoyment Scale (LES), with the anticipation that the outcomes will be published in another venue.

IntroductionThe Screaming Mummy of Cairo Egyptian-Museum Store, is an anonymous woman with a wide-open mouth coded as CIT8, discovered beneath Theban Tomb 71 (TT71) which is the burial site of Senmut’s relatives, the architect of 18th-Dynasty Queen Hatschepsut (1479–1458 BC). The study aims to evaluate if combining computed tomography (CT) with scientific investigations and archeological data of the Screaming Mummy CIT8 will reveal information about its physical appearance, health, cause of death, and mummification.MethodsWe CT-scanned the mummy and created reconstructed images. Scanning-Electron-Microscope (SEM), Fourier-Transform-Infrared-Spectroscopy (FTIR), and X-ray-Diffraction-Analysis (XRD) were used to investigate mummy skin, hair, and wig samples. We compared our findings to previous data.ResultsComputed tomography estimated the age of death to be 48.1 years ±14.6 based on the pubic symphyseal surface. CT detected mild-to-moderate teeth attrition, and joints degeneration. The desiccated brain and viscera remained in situ. FTIR revealed the wig is formed of midrib date palm that shows in CT as spiral low density fibers. The wig fibers are partially coated with a thick substance that is inspected as black consolidation and identified as crystalline by XRD, comparable to material found in an ancient wig-making workshop. FTIR showed that the skin, hair, and wig samples were treated with imported juniper resin had anti-bacterial and insecticidal properties. The skin and wig samples contained frankincense, and the hair sample contained henna.DiscussionCombining the advantages of paleoradiology to the scientific investigations, provided enhanced comprehension of the mummy CIT8 and ancient Egyptian wig structure and material. CT scanning non-invasively showed the mummy’s inner and exterior morphology, and estimated the age of death as 48 years. CT evaluated the mummification technique based on retained viscera and absence of embalming packs. The scientific tests revealed expensive imported embalming materials, contradicting the traditional belief that the non-removal of the viscera implied poor mummification, resulting in careless embalmers sealing the mouth. The widely opened mouth could be a result of facial expression of suffering before death, fixed by cadaveric spasm. The study also explores how rigor mortis, tissue decomposition, burial techniques, and postmortem alterations may contribute to a mummy’s screaming appearance.

In the present study, a bibliometric analysis of the published literature on Ecological Niche Modelling (ENM) topic from 1992 to 2023 was carried out using Web of Science (WoS) as a data source. Analysis of the data was carried out using bibliometrix tool in R software. Additionally, VOS Viewer software was used to provide visualization of the bibliometric analysis through network maps. The results of the study revealed that a total of 3, 595 scholarly documents in the English language were published on ENM from 1992–2023, originating from 564 sources. Furthermore, a significant increase in publications was observed over the years. A total of 13,122 authors have contributed to the field, with “Peterson AT” from the University of Kansas being the most prolific author. Journal of Biogeography emerges as the most relevant source with 290 documents published, while Ecography as the most cited source with 8,485 citations. Collaboration analysis revealed that only 109 documents were single-authored, with an average of 5.07 co-authors per document and an international co-authorship rate of 50.96%. Additionally, our analysis shows that the USA leads in Multiple Country Publications (MCP). The development of sophisticated software tools and algorithms coupled with remote sensing data has democratized ENM research, enabling scientists from diverse backgrounds to contribute to the field’s growth. However, like any other model ENMs have some limitations and thus the entire procedure used to create an ENM must be reliable, transparent, and repeatable in order for it to be used effectively in conservation, management and decision-making.

The impact of learning enjoyment on motivation, enthusiasm, and overall learning experiences is significant. Previous studies, lacking an unbiased tool for measuring enjoyment and confronting various influencing factors, produced conflicting results regarding enjoyment levels in different instructional methods. Hence, we developed a learning enjoyment scale for evaluating both active and passive educational activities. We applied the developed scale to 112 first-year medical and dental students to assess their enjoyment during didactic physiology lectures and explored possible associated factors. Within this data note, we present students’ responses to the developed LES. The LES encompasses six dimensions: knowledge, comprehension, application, analysis, concentration, and enjoyment. Students provided ratings for each dimension on a five-point Likert scale, spanning from 1 (strongly disagree) to 5 (strongly agree). The cumulative scores across the six dimensions range from a minimum of 6 to a maximum of 30. These total scores can be categorized as excellent (> 24), acceptable (18-24), or low (< 18). The second section of the dataset examines specific factors influencing overall enjoyment, such as teacher proficiency, topic difficulty, active student participation, objectives fulfillment, low stress levels, and self-perceived acquisition of skills. In addition to objective measurement of students’ enjoyment level, the LES can be utilized for quantitative cross-comparisons between different teaching activities. By employing this dataset, we will undertake an analysis to determine the internal consistency of the Learning Enjoyment Scale (LES), with the anticipation that the outcomes will be published in another venue.

Among the various systems taught in the preclinical phases, the nervous system is more challenging to learn than other systems. In this report, a novel teaching methodology, "real-life scenario (RLS) blended teaching," is described and its effectiveness in facilitating inquisitive learning in undergraduate medical students is evaluated. This mixed-method study was conducted among three groups ("group 1," n = 83; "group 2," n = 85; and "group 3;" n = 79) of undergraduate medical students (18--20 yr) in the neurology and behavioral sciences module. RLS was presented to students in the form of demonstrations, role-plays, videos, and group activities. "Group 1" students underwent traditional teaching-learning sessions. "Group 2" students underwent RLS blended sessions and were provided with multiple miniassignments in a vignette format. "Group 3" students received RLS blended sessions, multiple miniassignments, peer discussions, multiple formative assessments, and facilitator feedback sessions. The student performances on different exams were compared in terms of their group, and their perceptions of RLS were documented. Students exposed to RLS sessions blended with multiple assignments, peer discussions, multiple formative assignments, and facilitator feedback sessions performed well in the final summative assessments (67.87%) compared with those exposed to RLS sessions and assignments (50.21%) or exposed to traditional teaching alone (50.34%). RLS sessions increased students' curiosity and motivated them to learn the subject well. RLS sessions stimulated student interest and facilitated their learning. RLS along with effective use of multiple assignments, formative assessments, and/or feedback sessions significantly improved student learning. This demonstrates the effectiveness of this active method in teaching various subjects with appropriate modifications.

Jhancy Malay,1,&ast; Imran Rashid Rangraze,2,&ast; Tarig Hakim Merghani,3 Salah Eldin Kassab4,5,&ast; 1Department of Pediatrics, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 2Department of Medicine, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 3Department of Physiology, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 4Department of Medical Education, College of Medicine, Gulf Medical University, Ajman, United Arab Emirates; 5Department of Physiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt&ast;These authors contributed equally to this workCorrespondence: Jhancy Malay, Department of Pediatrics, RAK Medical and Health Sciences University, PO Box 11172, Ras Al Khaimah, United Arab Emirates, Tel +971 72043000, Fax +971 72269997, Email jhancy@rakmhsu.ac.aePurpose: The teacher-student dyad is the heart of an institute. A teacher’s instructional role significantly influences the student engagement that indirectly measures the institutional outcome. The online transition of medical education changed the milieu of medical education where a virtual link between teacher and student is the only hope for the learner to continue the learning. There were no studies on the relationship between student engagement and teaching styles during online medical education.Patients and Methods: The present study was an online survey-based descriptive study on medical undergraduates from two universities in the United Arab Emirates. Google forms containing consent statements, teaching styles inventory in higher education (TSIHE), and online student engagement questionnaires were emailed to all medical students requesting to participate in the study. Completed survey questionnaires were analyzed descriptively for the degree of student online engagement, and a chi-square test was used to correlate the relation between faculty online instructional methods and students’ engagement.Results: A total of 423 of 927 students from two universities participated in the survey. There was no significant perception difference among the students from the two universities regarding their faculty online teaching styles. Thirty-three percent of students at first university and 41% of second university students showed engagement during online classes, which is statistically significant. However, the degree of students’ disengagement from both universities was high compared to their engagement for online classes. Both university students’ cognitive and behavioral engagement was moderate to strongly correlated with four domains of teaching style. Interestingly, there was no correlation between online faculty instructional methods and students’ psychological engagement from both the universities.Conclusion: The present study establishes the relationship between students’ cognitive and behavioral engagement and teaching instructional practices. However, there is a need to develop robust evidence on students’ psychological engagement and the influencing factors during online and blended contexts.Keywords: student engagement, teaching styles, perceptions, online medical education, relationships between teaching style and student engagement

The impact of learning enjoyment on motivation, enthusiasm, and overall learning experiences is significant. Previous studies, lacking an unbiased tool for measuring enjoyment and confronting various influencing factors, produced conflicting results regarding enjoyment levels in different instructional methods. Hence, we developed a learning enjoyment scale for evaluating both active and passive educational activities. We applied the developed scale to 112 first-year medical and dental students to assess their enjoyment during didactic physiology lectures and explored possible associated factors. Within this data note, we present students’ responses to the developed LES. The LES encompasses six dimensions: knowledge, comprehension, application, analysis, concentration, and enjoyment. Students provided ratings for each dimension on a five-point Likert scale, spanning from 1 (strongly disagree) to 5 (strongly agree). The cumulative scores across the six dimensions range from a minimum of 6 to a maximum of 30. These total scores can be categorized as excellent (> 24), acceptable (18-24), or low (< 18). The second section of the dataset examines specific factors influencing overall enjoyment, such as teacher proficiency, topic difficulty, active student participation, objectives fulfillment, low stress levels, and self-perceived acquisition of skills. In addition to objective measurement of students’ enjoyment level, the LES can be utilized for quantitative cross-comparisons between different teaching activities. By employing this dataset, we will undertake an analysis to determine the internal consistency of the Learning Enjoyment Scale (LES), with the anticipation that the outcomes will be published in another venue.

Background: Malnutrition increases the risk of developing tuberculosis (TB) and causes reactivation of latent pulmonary TB. On the other hand, TB is a recognized cause of malnutrition. Evaluation of the nutritional status and anemia of tuberculous patients with active disease is an important step toward TB management. The objectives of the study were to determine the nutritional status and patterns of anemia in adult patients with active pulmonary TB. Methods: A cross-sectional hospital-based study was performed on newly diagnosed patients with sputum-positive pulmonary TB. The nutritional status, total percentage of body fat (BF%), anemia, and general health of each patient were assessed with measurements of the body mass index (BMI), skin fold thickness, complete blood counts, and biochemical tests. Results: Patients' ages ranged from 16- to 74-year old, with the majority between 20- and 40-year old. Male: female ratio was 2:1. The majority of males and females (91.2% and 84.5%, respectively) had low BF%. Underweight (BMI < 18.5) was 62%, whereas overweight (BMI ≥25.0) was 4%. BMI showed a significant decline with chronicity of the illness (P < 0.001). Eighty participants showed anemia, 90% microcytic hypochromic, and 10% normocytic normochromic. Serum albumin was low in 21%, with no relation to renal disease and insignificant association with proteinuria. Conclusion: Patients with active pulmonary TB are likely to have microcytic hypochromic anemia, low BF%, and low BMI, especially with a long duration of the disease.

Although traditional didactic lecturing is the principal instructional approach used in numerous medical schools, this method has several limitations. Experiential learning approaches place students in the center of the learning process and creates a positive and supportive classroom learning environment. In this article, we propose an active pedagogical approach for teaching a basic physiology concept, namely, neuromuscular transmission (NMT), and we evaluate the effectiveness of this approach among undergraduate medical students. One-hundred forty-two undergraduate medical students were involved in this study ("cohort A, n = 62"; "cohort B, n = 80"). "Cohort A" received a didactic lecture on NMT and subsequently tested their knowledge of the topic via "test 1," after which their perceptions of didactic lectures were recorded. The students were then asked to participate in a touch-and-go (TAG) active-learning session regarding NMT, after which their learning was subsequently tested by taking "test 2." Their perceptions about the TAG game were also recorded. Students in cohort B were first administered "test 1" regarding NMT. Then, they were asked to attend a didactic lecture blended with a TAG active-learning session, after which "test 2" was administered, and their perceptions were recorded. Both the didactic lecture and active learning sessions facilitated student learning regarding the concepts involved in NMT. A comparison of the lecture followed by the game used in "cohort A" with the game blended lecture used in "cohort B" revealed no significant differences. However, both formats created a positive influence on students' interest in learning the concept, and the students preferred active learning over didactic sessions alone.

Abstract Background The impact of cancer extends beyond patients and consumes their families. Family members are widely recognized as informal caregivers. The economic burden on family caregivers is increased with new treatments, prolonged survival, and reduced stay in the acute care setting. This is especially true in African countries where family bonds are sacred and health system is fragile that they need to pay out of pocket for care. The aim of this study is to estimate the perceived caregivers’ economic burden in the subsequent aspects: financial strain, inability to make ends meet, not enough money for necessities, and economic adjustments/cutbacks. Method This study was a quantitative, descriptive cross-sectional study conducted at Khartoum oncology hospital. Included 143 caregivers of cancer patients. Data were collected through face-to-face interviews using the socio-demographic Questionnaire and Economic Hardship Questionnaire (EHQ). Results One hundred forty-three cancer patients and their caregivers were included. 56.6% of patients were females, and about 32.2% were aged 51–65 years. The most common cancer types were breast cancer and leukemia. Roughly 33% of patients had stage IV cancer on presentation, and about 53.9% received chemotherapy. Unlike cancer patients, (47.6%) of family caregivers were aged 18–34 years, yet they were mainly females (54.4%). Most of them (34.3%) were unemployed, with a mean monthly gross income of 53.3 dollars, while the mean household monthly gross income was 113.0 dollars. The mean score of the economic hardship scale was 35.8 out of 64. Most of the caregivers experience no difficulties affording necessities. However, they experience difficulties with medical and leisure activities. There was no significant association between caregiver economic hardship and cancer patient characteristics (patients' age, cancer stage, and treatment type). However, there was a significant association between caregivers' economic hardships and their gender, marital status, educational level, occupation, caregiver monthly gross income, and household monthly gross income. Conclusion The study findings suggest a moderate financial burden among cancer caregivers. The predicting factors include being single, a student, male, of higher educational level, and lower income. Financial difficulties are associated with maladaptive behavior and should come to light.

Jhancy Malay,1 Salah Eldin Kassab,2,3 Tarig Hakim Merghani,4 Ramya Rathan,5 Anusha Sreejith6 1Department of Pediatrics, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 2Department of Medical Education, Gulf Medical University, Ajman, United Arab Emirates; 3Department of Physiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 4Department of Physiology, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 5Department of Anatomy, College of Medicine, Gulf Medical University, Ajman, United Arab Emirates; 6Department of Demography, College of Medicine, Gulf Medical University, Ajman, United Arab EmiratesCorrespondence: Jhancy Malay, Department of Pediatrics, RAK College of Medical Sciences, RAK Medical and Health Sciences University, PO Box 11172, Ras Al Khaimah, United Arab Emirates, Tel +971 72043000, Fax +971 7 226 9997, Email jhancy@rakmhsu.ac.aeIntroduction: An unprecedented disruption in medical education worldwide was caused due to the Covid 19 pandemic. Online teaching has become one of the primary forms of education. In this paper, we aimed to understand the faculty and students’ perceptions about the teaching styles adopted by the faculty during online large group teaching from two universities in the United Arab Emirates.Patients and Methods: This is a cross-sectional opinion survey-based study. A pre-validated teaching style inventory in higher education (TSIHE) questionnaire was emailed to the students and faculty involved in large group online learning and teaching activities during the lock-down period of the COVID 19 pandemic from two different medical Universities in the United Arab Emirates. A total of 423 students and 57 faculty participated in the study. Descriptive and Inferential statistics were used to analyze the data.Results: There was a significant difference between the faculty and students on the perception of faculty online teaching styles. The difference was significant in teacher-student interaction and teacher structuring styles. In contrast, faculty and students’ perceptions were comparable for decision-making negotiation and behavioral control teaching styles.Conclusion: The study found that there was a significant perception differences between the faculty and students on the faculty teaching style during online large group teaching. Importantly, faculty perceived that they were more emotionally attached and more flexible in teacher-student interaction and teaching structuring during online teaching than the student perceived.Keywords: COVID 19, medical education, online large group teaching, medical students, faculty perception

Background: Acute childhood diarrhea is one of the most common causes of dehydration, and if severe, can potentially lead to death as well. The present study was aimed at evaluating the knowledge and attitudes of community pharmacy professionals towards the management of acute childhood diarrhea and comparing them with their actual practices in Jazan Province, Kingdom of Saudi Arabia (K.S.A). Methods: Simulated patient visits and a cross-sectional survey making use of a 27-item self-report questionnaire were conducted amongst a sample of 303 community pharmacy professionals (51.2 % male and 48.8 % female) with an age range of 25–56 years, between August 1 and December 1, 2021, in Jazan Province, Saudi Arabia. Convenience sampling technique was used for the recruitment of the participants. Results: Significant positive correlations were seen between knowledge score (self-report survey) and practice score (simulated patient visit) regarding patients’ history taking (r = 0.65; p

Background and Objectives. The enzyme methionine synthase reductase is involved in cellular methylation reactions, DNA synthesis, and epigenetic processes. It is encoded by the MTRR gene, which garnered a lot of attention in current medical genetics research. This study was conducted to study the association between MTRR (A66G) polymorphism and the risk of developing acute lymphoblastic leukemia among Sudanese patients. Materials and Methods. This is a case-control study in which 150 patients with acute lymphoblastic leukemia (ALL) and 150 healthy participants as a control group were enrolled. DNA was extracted and analyzed for the MTRR (A66G) polymorphism using the real-time polymerase chain reaction. Results. Based on flow cytometry results, B-ALL was more common (79%) than T-ALL (21%). The comparison of hematological parameters in acute lymphoblastic leukemia subtypes showed a statistically significant high mean total white blood count (P=0.000) and mean blast percentage (P=0.050) in patients with T-ALL. The molecular analysis showed that the incidence of the MTRR homozygous genotypes AA and GG were higher in the patients (44% and 9.3%, respectively) compared to the control group (40% and 6.7%, respectively). In comparison, the heterozygous genotype AG was lower in the patients (46.7%) than in the control group (53.3%). However, the association between the polymorphism and acute lymphoblastic leukemia risk was not statistically significant (OR: 1.179, 95% CI 0.7459-1.865, P=0.445). Conclusions. This study concluded that MTRR A66G polymorphism was not associated with the risk of acute lymphoblastic leukemia among the Sudanese population.

Artificial Intelligence (AI) driven documentation systems are positioned to enhance documentation efficiency and reduce documentation burden in the healthcare setting. The administrative burden associated with clinical documentation has been identified as a major contributor to health care professional (HCP) burnout. The current systematic review aims to evaluate the efficiency, quality, and stakeholder opinion regarding the use of AI-driven documentation systems. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines a comprehensive search was conducted across PubMed, Embase and Cochrane library. Two independent reviewers applied inclusion and exclusion criteria to identify eligible studies. Details of AI technology, document type, document quality and stakeholder experience were extracted. The review included 11 studies. All included studies utilised Chat generated pretrained transformer (Chat GPT, Open AI, CA, USA) or an ambient AI technology. Both forms of AI demonstrated significant potential to improve documentation efficiency. Despite efficiency gains, the quality of AI-generated documentation varied across studies. The heterogeneity of methods utilised to assess document quality influenced interpretation of results. HCP opinion was generally positive, users highlighted ease of use and reduced task load as primary benefits. However, HCPs also expressed concerns about the reliability and validity of AI-generated documentation. Chat GPT and ambient AI show promise in enhancing the efficiency and quality of clinical documentation. While the efficiency benefits are clear, the challenges associated with accuracy and consistency need to be addressed. HCP experiences indicate a cautious optimism towards AI integration, however reliability will depend on continued refinement and validation of the technology. [ABSTRACT FROM AUTHOR]

Background: The UN General Assembly recognised the human right to water and sanitation through the sixth SDG in 2010. South Kordofan, a state in southern Sudan, faces WASH challenges due to conflict, geographical factors, and inadequate services, impacting over 600,000 residents. Such conflicts are well known for spreading diseases and disrupting WASH-related practices among displaced individuals. Objectives: The study aimed to evaluate the quality and availability of drinking water, as well as sanitation and hygiene practices in rural South Kordofan. It also sought to identify factors affecting community satisfaction with WASH services and to establish a data-driven basis for future interventions addressing these issues. Methods: A cross-sectional study accompanied a medical mission to South Kordofan, selecting 33 villages from South Kordofan based on healthcare, population, and accessibility. Water samples, patient forms and questionnaires were collected using convenient sampling for targeted villages and for attendants of mobile clinics. Laboratory analyses were conducted on water samples. Descriptive statistics, univariate analysis and logistic regression were used to analyse the data. The used level of significance was 0.05. Results: Out of 784 participants, 60.2% were female. Tube wells/boreholes were the primary water source (68.1%), and most participants (70.9%) lived near their water source (less than 30 min). Dissatisfaction with water services was reported by 56.8%, and satisfaction associated with method of delivery (OR = 0.081, CI = 0.024–0.276)), appearance (OR = 0.299, CI = 0.182–0.489), distance (OR = 0.264, CI = 0.099–0.705), water unavailability (OR = 0.477, CI = 0.297–0.765), and obligation to pay (OR = 0.351, CI = 0.185–0.665). Samples showed high levels of contamination, both microbial and physicochemical. Regarding sanitation, over a third of the participants (41.5%) disposed of children's stool by leaving it outdoors. About 10% of the participants reported having diarrhea during the week before the study. However, about two-thirds of the participants (68.1%) showed good hygienic practices by using soap or detergents for hand washing. Conclusion: The study revealed inadequate WASH services, high microbial contamination, and poor water treatment practices. Paradoxically, many participants expressed satisfaction with water services. Sanitation issues and open defecation persist, emphasizing the need for comprehensive interventions. All these negative consequences can be attributed to the armed conflict which resulted in poor awareness about the safety of drinking water, what safe water looks like and proper hygiene practices. Moreover, these conflicts led to disruption of the economical status leading to the absence of proper water purification infrastructure. [ABSTRACT FROM AUTHOR]

The anticancer activity of silver nanoparticles (AgNPs) is well known to be synthesized using green-synthesized methods, although its mechanism of action is not understood fully. Moringa oleifera leaves were used as reducing and stabilizing agents to synthesize AgNPs. Green-synthesized AgNPs were characterized using ultraviolet-visible spectroscopy, dynamic light scattering, transmission electronic microscopy, scanning electronic microscopy, Fourier transform infrared, and energy-dispersive X-ray spectroscopy analyses. The synthesized nanoparticles were then characterized by their anticancer properties by performing a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The real-time polymerase chain reaction was used to check the expression levels of the four genes (β-catenin, adenomatous polyposis coli (APC), and lipoprotein receptor-related proteins 5 and 6 (LRP5/6)). The synthesized nanoparticles were 25 nm on average and spherical in shape and aggregated form. Noteworthy cytotoxicity is how green-synthesized M. oleifera–AgNPs were observed in comparison with the M. oleifera leaf extract against a cancerous cell line. The M. oleifera–AgNPs decreased the expression of CTNNB1 and LRP6 genes, while the LRP5 gene expression increased in both cell lines. With treatment, the APC gene expression decreased in SW480 but increased in HTC116. Our results imply that AgNPs synthesized by M. oleifera extract could be an ideal strategy to combat colon cancer.

Nanoparticles synthesized from plants are being explored for cancer treatment therapies all over the world. This study reported the eco-friendly and low-cost method for the green synthesis of silver nanoparticles (AgNPs) from Adansonia digitata fruit as a reducing and capping agent. The anti-cancer potential of synthesized particles was explored against HTC116 and SW480 colon cancer cell lines. Prepared AgNPs were characterized by ultraviolet-visible spectroscopy, zeta potential, transmission electronic microscopy, scanning electronic microscopy, Fourier transform infrared, and energy-dispersive spectrum. The cytotoxicity was determined with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and expression levels of four genes (CTNNB1, APC, LRP5, and LRP6) were checked by reverse transcription polymerase chain reaction. The sharp peak of surface plasmon resonance at 400 nm confirms the formation of AgNPs. Dynamic light scattering showed average sizes of 16.34 nm with a polydispersity index of 0.193. A. digitata AgNPs were spherical with slight aggregated. AgNPs were more cytotoxic than A. digitata extract and decrease the expression of CTNNB1 and LRP6 genes while LRP5 gene expression was increased in both cell lines. APC gene expression was decreased in SW480 but increased in HTC116 with treatment. Overall, this study suggested that AgNPs synthesized by A. digitata fruit extract can be an attractive candidate for anticancer applications.