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Background: Operating room contamination is recognized as one of the most common life-threatening microbial contaminations in hospital environments, especially operating rooms and other specialty units, and is an ever- increasing cause of nosocomial infections. Objective: The purpose of this study was to isolate and identify bacterial contaminants in Shendi hospital operating room. Between July-September 2021. Materials and Methods: Sixty samples were collected from various locations in the operating room and all isolated bacteria were identified. The study isolated five types of bacteria from the Shendi Hospital operating room. Results: The results showed that Micrococcus was the most common bacterial contaminant isolated from the operating room. Leteus 21 (32.3%) Staphylococci. Epidermis 16 (24.6%), Staphylococci aureus 11 (16.9%), Bacillus sp. 9 (13.8%), Bacillus cereus 8 (12.3%)) and the lowest contaminants were isolated from soil 15 (23%), and focus lamp 5 (7.7%). This study may point to the fact that the Shendi Hospital operating room had bacterial contamination that could lead to postoperative wound infections (SSI). Reasons for contamination may be due to excessive attendance, personnel movement, and ineffective sterilization and disinfection procedures. Conclusions: Bacterial contamination was highest in operating room beds, followed by carts, floors, and focused lambs. Micrococcus spp, S. epidermidis, S. aureus, and Bacillus species have proven to be the most serious contaminants in the operating room, and are a dangerous cause of hospital-acquired infections, killing patients and hospital staff threatening. This may indicate that the sterilization method is not efficient enough, putting the patient at risk for postoperative infection. Some organisms were resistant to Gentamicin and highly sensitive to Imipenem, Ciprofloxacin, and Ceftriaxone.

Background: Urinary tract infections frequently occur in diabetic patients due to an impaired immune status and increased glucose content in the urine among other reasons. This makes UTIs very important to investigate. Complicated cases of UTI may be frequent but are more common in diabetics with more severe consequences. And so warrant further investigations. The proper management of UTI in diabetics is crucial as prompt diagnosis and correct use of antibiotics are vital for treatment. Finding alternative antimicrobial agents from plant extracts has received growing interest. Ginger (Zingiberofficinale) is a safe, non-toxic, cheap spice that has been reported to have antimicrobial effects against various pathogenic bacteria. Objectives: This study aimed to evaluate the effectiveness of ginger extract on different types of bacteria isolated from diabetic patients suffering from urinary tract infections. Methodology: A cross- sectional and hospital-based study has been conducted at the University of Shendi –faculty of medical laboratory sciences- department of microbiology from May to November 2018. Following informed consent, 100 diabetic patients suffering from UTI of different ages were enrolled in this study. Sixty-two bacteria were isolated, different Gram- positive and Gram-negative bacteria, in vitro sensitivity testing using a well diffusion technique against ginger extract. Results: The main causative agent of UTI in the study population was E. coli 32.3% then S. aureus 29%, S. saprophyticus 29%, and E. faecalis9.7%. The largest diameter of the inhibition zone appeared in Gram-positive S.saprophyticus (13.4mm). The concentrations of ginger extract used were 100, 50, 25, and 12.5 mg/ml. mean of inhibition zone of chloramphenicol for isolated bacteria S.aureus 31mm, S.saprophyticus 20.2 mm, E.coli 17.7mm, and faecalis24.6mm. Conclusion: The antimicrobial activity of the crude extract was compared with that of standard antimicrobial chloramphenicol based on the mean diameter of the inhibition zone. The extract exhibited maximum relative percentage inhibition against S.saprophyticus(42.3%) and minimum relative percentage inhibition against S. aureus (6.3%).

Background: Coronaviruses are large groups of viruses that cause illness in humans and animals. This virus has a higher degree of lethality than other endemic viruses Covid-19 diagnosis is based on viral detection, isolation, or serological changes. For cytopathic effects, sputum cytology is routinely performed for nearly all patients with chest symptoms. Objective: The study aimed to find Cytological change in sputum samples of COVID -19 patients in Shendi town. Materials and Methods: This study includes 45 subjects. Thirty were known as Covid 19 positive cases by PCR, and 15 were healthy subjects. Two sputum smears were collected from the study group then fixed in (95% Ethanol alcohol) and stained with Papanicolaou and Giemsa stains, then screening for any cytomorphological changes and microbes. Result: In cytology screening, intranuclear inclusion and inflammatory cells were observed in all sputum samples (100%) of patients infected with covid-19, other cytomorphological changes that appeared were nuclear atypia (96.6%), cytolysis (64.4%) and destructive change (fibrocytes) in (30%). None of the cytomorphological changes mentioned above were observed in the control sample. Co-infection with bacteria and fungi (aspergillus & Candida) exists in (66.6%) of Covid-19 patients. There was a statistically significant correlation between infection with covid-19 and the cytomorphological changes characterized in their sputum P. value was less than (0.05). Intranuclear inclusion in this study was a specific and sensitive indicator for Covid-19. There was no correlation between the period of infection and distractive change appearance or invasion with micro-organisms of the study group (P. value more than 0.05), But confections with microorganisms were statistically correlated to the age of the study group (P. value less than 0.05). Conclusion: Cellular changes and consistency of Sputum and saliva samples can provide inexpensive, rapid diagnostic, minimally invasive techniques for Covid-19, particularly in densely populated developing countries and areas.

Introduction: One of the most serious issues in medicine is the increasing resistance of Enterobacteriaceae to antimicrobial agent’s especially broad-spectrum antibiotics such as Cephalosporins and Penicillins. This fact is associated with higher mortality and morbidity rates, prolonged hospital stays, and increased treatment-related costs. Carbapenems are the last line for the treatment of infection caused by bacteria resistance to a broad spectrum of antibiotics. Objective: This study aimed to detect the Distribution of Carbepanems Resistance in Enterobacteriaceae Pathogens Isolated from Clinical Samples in the Shendi locality Method: Cross-sectional study and a laboratory-based study was carried out on 63 isolates from different specimens, 63 types of pathogenic bacteria were isolated and identified using Gram stain, biochemical reactions, and testing for their susceptibility to Carbapenems antibiotics was performed for all Enterobacteriaceae isolates. Result: The isolated Enterobacteriaceae comprising of 19.0(30.2%) E. coli, 17 (27.0%) K. pneumoniae, 13(20.6%) P. vulgaris, 5(7.9%) P. mirabilis, 1(1.6%) Enterobacter species, 3(4.8%) C.freundii and 5(7.9%) M. morganii.Carbapenem (Imipenem and meropenem) susceptibility testing showed that 36.0% of Enterobacteriaceae isolates were Carbapenem resistant.Conclusions: The study revealed the low resistance pattern of Enterobacteriaceae to Carbapenems. Despite that E. coli (19.0, 30.0%) was the most isolated organism, K. pneumonniae (7.0, 11.0%) was the most resistant isolate to Carbapenems. The urine sample had the highest degree of resistance. There was a correlation between patients with chronic diseases such as cancer and the resistance level to Carbapenems, while there was no statistical significance between the period of antibiotics usage and the degree of resistance.

Background: Schistosomiasis is a debilitating disease, infects millions of people in tropical and subtropical regions. Objectives: This study assessed the situation of the urinary schistosomiasis among the people of the Alsyal village, River Nile State, Sudan. Methods: A cross-sectional survey was carried out in 2016, in the Alsyal village, and 220 samples of urine were collected and processed using the centrifugation/sedimentation technique. Results: The overall prevalence and intensity of the disease among the pupils studied were 4.1% and 95.9 eggs/10ml urine, respectively. The prevalence of infection among male pupils was 77.8%, and for females was 22.2%, while the intensity among males was 64.9eggs/10ml and for females was 35.1 eggs/10ml urine. The highest infection rate (71.4%) was reported among the 12- 24 years age group, while the infection was (14.3%) among less than 12 years and more than 24 years age group. Conclusion: Findings show the need for an integrated control program against urinary schistosomiasis including the treatment of all infected the people and the implementation of a health education program.

This study aimed to evaluate the antifungal activity of Cinnamon extract on Candida species isolated from 100 diabetic patients suffering from urinary tract infection between May to August 2018. Twenty-five Candida species were isolated, different Candida species were isolated then identified biochemically, in vitro sensitivity testing using well diffusion technique against Cinnamon extract was done. The cinnamon extract showed good antifungal activity against Candida species. The largest zone of inhibition against Candida tropicalis was (25 mm) and the least zone of inhibition was against Candida kefyr was (10 mm). The results of antimicrobial activity of crude extract were compared with the positive control (Clotrimazole) for evaluating their relative percentage inhibition and statistical significance the aqueous extract exhibited maximum relative percentage inhibition against Candida kefyr (89%) and minimum relative percentage inhibition against Candida glabrata was (12.3%). The p. values (0.018) are statistically significant.

Rota virus is the second causes of diarrhea among childrenIn Sudan [2]. The current study was conduct to detect rotavirus gastroenteritis among vaccinated children Methodolgy: A total of59 diarrheal samples was collected from children with acute diarrhea admittedto Mohammed AL Amin Hamid paediatric Hospital throw period from October to November 2019, ELISA was dine to detect Rota virus antigen. Result: Out of 59 samples 84.7% was vaccinated were 15.3% was unvaccinated.in total of 50 vaccinated children 30% is re-infected with rota virus with acute to chronic illness and show positive antigen with ELISA. Conclusions: vaccinated children is infected with rota virus and symptoms is occurs samples for virus antigen was record positive result in ELISA this may related to other genotype or serotype or mutation.

Background: The fifth Millennium Development Goal aims for a decrease in maternal mortality and universal access to high-quality reproductive health care. Every year, around a third of a million women die as a result of pregnancy-related complications. Three-quarters of these deaths might have been avoided. One of the most important markers of mother and child health care is the Maternal Mortality Ratio. One of the most significant aims of the national family welfare program is to reduce maternal fatalities are thought to be preventable. Objective: The study's focus is to document, investigate, and report the events and circumstances behind maternal fatalities, as well as to study maternal deaths in River Nile State in order to identify the maternal mortality rate and causes of death. Methodology: This is a hospital and community-based research that took place from January to December 2018 at River Nile State. Information on every maternal death was obtained using a questionnaire which was filled out and rechecked to completely cover State, and then analyzed using SPSS version 20. Results: The overall number of live births was 25988, with 29 incidents of maternal death. 112/100000 live births was the death rate. 27 of the patients (93%) died in a hospital, whereas two instances (7%) died at home. Obstetric hemorrhage was the leading cause of maternal death in seven cases (24.1%), followed by hypertensive disorders in seven cases (24.1%), sepsis in four cases (17.2%), indirect obstetric causes in three cases (10.3%), embolism (PE & AFE) in three cases (10.3%), unclassified causes in four cases (13.7%), and abortion in one case (3.4 %). The bulk of the cases were delayed at home (14 cases, 48.3%), with 10 cases (34.4%) having no delay and five (17.2%) being delayed in reaching hospitals. Unfortunately, 19 instances (65.5%) died as a result of preventable causes. Conclusion: In 2018, the maternal death rate in River Nile State was 112/100,000 live births, which was higher than in the previous report. Maternal fatalities were mostly caused by hemorrhage, hypertensive diseases, and sepsis. The bulk of deaths were postponed until they reached their final destination.

Background: Covid-19 can Cause Various Conditions Including respiratory, enteric, and neurological diseases, and led to a pandemic that has affected millions worldwide. Methods: This is a cross-sectional descriptive study conducted at Shendi teaching hospital which is located in Shendi town in Sudan to evaluate Haematological parameters and D. Dimer in patients with Covid-19 Infection in the period between May to September 2021. The study included (50) patients who were diagnosed with Covid-19 Infection and the study groups were compared with (50) healthy volunteers as a control group. 50 venous blood samples as case and 50 as control transferred into Tri sodium citrate and EDTA anticoagulant. Data was collected using a questionnaire and the (SPSS) version (22) program was used for data analysis. Results: The study revealed that the Covid-19 Infection patients were; (60%) males and (40) females. Complete blood count (CBC) indicated the mean values of Hb, PCV, RBCs, MCV, MCH, MCHC, in case group were (12.5 g/dl), (38.9%), (4.5x1012/l), (86.7 fl), (27.7 pg) and (32.0 g/dl) respectively. Also prevailed the mean of TWBCs, Neutrophil, lymphocyte, MID, Absolute Neutrophil, Absolute lymphocyte, Absolute MID, were (13.09x 109 /l), (79.27%), (11.79%), (8.77%), (10.38), (1.54), and (1.16) respectively. The study revealed the mean of platelet, D.dimer (296.63x 109 /l), (6.07ug/ml), respectively. Conclusions: Covid-19 Infection is responsible for significant changes in hemoglobin, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration, total white blood cells count differential and absolute neutrophils count and differential and absolute lymphocytes count and D. dimer.

Background: Breast cancer is common in Sudan and most patients are detected at later stages of the disease due to the lack of awareness and absence of early screening programs. The majority of breast cancers originate in the epithelium lining the milk ducts. It is believed that most breast canceras are slow growing and progress from precancerous cells, which have cellular and nuclear changes that can be identified microscopically. Aim: To cytological screening of breast cancer in breast fluid. Methods: This is a cross-sectional feasible study conducted in Shendi town, 200 samples of different breast fluids from asymptomatic women. (100 nipple aspiration fluid, 50 milk smear, 50 postpartum milk) have been collected and screened cytologically. Stained by pap stain. Results: After cytology screening of breast fluid in, milk 30/50(60%) of women were non-cell secretors and 20/50 (40%) of women were cell secretors. Cells that appeared among the secreting group were a few epithelial cells and immune cells. In postpartum milk all women 50/50 (100%) were cell secretors, abnormal cytomorphological changes were in 15/50 (30%) of them, and high secretion of immune cells 50/50 (100%) which found to statistically of significant value (0.000). NAF was not produced in 78/100. Among women who produced NAF22/100, women were produced NAF 6/22 (27.3% ) were not cell secretors (category 0), benign nonhyperplasic ductal epithelial cells (category 1) 6/22( 27.3%), benign hyperplasic ductal epithelial cells (Category II) 5/22( 22.7%), atypical ductal epithelial cell (category III) 3/22 (13.7%) atypia (Category IV) 2/22(9%). cytological atypia 21/25 (84%) appears among women more than 30 years old and there was a strong statistical of significant value P. value =(0.000). Also, risk factors (family history, contraceptive intake, and HPV) statistically have a significant correlation with cytological atypia among study group P. value = (0.036). In this study HPV infection, cytomorphological change (koilocyte) was detected in breast fluid 4/200 (2%). Conclusion: cytology of the breast is a simple, safe, rapid test that is acceptable to patients and showed the ability to detect benign and pre-neoplastic ductal epithelial cells from asymptomatic volunteers.

Moringa oleifera grown and used in many countries around the world is a multi-purpose tree with medicinal and nutritional values. This study evaluates the effect of taking moringa oleifera leaves powder on blood sugar levels in humans, and study side effect on kidney (urea, creatinine) and liver enzyme (AST, ALT) after taken leaves powder for a month. The study targeted patients who their blood glucose not lowering by drugs. Blood glucose, urea, creatinine, AST and ALT for all diabetic patients was determined before and after taking 0.5g leaves powder. Results showed blood sugar levels decreased statistically significant (p

Background: Aim: Estimation of alkaline phosphatase levels in prostate cancer patients attending the National Cancer Institute of Gezira University to determine the association between elevated alkaline phosphatase levels and metastases in prostatic cancer patients. Methods: This is a descriptive cross-sectional hospital-based study to estimate alkaline phosphatase enzyme levels in patients with prostatic cancer who attended National Cancer Institute, Gezira University's between September and December 2018. A structured questionnaire was developed and prescribed to 100 subjects, which included personal and medically important information. The level of alkaline phosphatase was determined, and a biopsy was performed, with the results interpreted by a histopathologist. SPSS-23 was used to analyze the data. Results: Patients with metastatic prostatic cancer accounted for 50% of the patients in the research, and 51% of them had an alkaline phosphatase level greater than (124U/L). Bone metastasis was the most prevalent site of metastasis, accounting for 50% of all cases, whereas liver metastasis accounted for 12% of all cases. Radiation prostatectomy plus radiotherapy was the most prevalent treatment for prostatic cancer, accounting for 86 % of cases. In comparison to individuals with non-metastatic prostate cancer, the majority of patients with metastatic prostatic cancer had an elevated alkaline phosphatase. Conclusion: Finally, we discovered that the level of alkaline phosphatase is significantly raised in patients with metastatic prostate cancer. Early detection and treatment will limit the impact of this serious condition.

Background: CVA is the loss of brain function due to a disturbance in the blood supply of the brain. This disturbance is due to either ischemia or hemorrhage. Aim: To study the major risk factors & presentation among patients with stroke in Atbara teaching hospital. Methodology: Cross-sectional descriptive hospital based study was conducted in Atbara teaching Hospital from February 2021 to April 2022. The data was collected by interviewing the patients through a closed-ended questionnaire and analyzed by using the statistical computerized program SPSS. Results: In our study, we found that 86.2%of study group their age group was more than 51years and most of them are males, 73.1% of them had a hemiplegic weakness, 60.8% of them had a transient ischemic stroke,90% had an ischemic stroke, 66.9% with one attack of stroke,77.7% of them have a chronic illness,53.1%have diabetes,63.8% have hypertension,28.5% of them have ischemic heart disease,23.8%have atrial fibrillation,11.5% have the valvular disease, 35.4 % of them are smokers and 6.9% are drinking alcohol. Conclusion: The study concluded that stroke increased with age above 51 years old and most commonly in males. The most common risk factor is HTN, DM, and heart disease. The common risk bad habit in strokes patients are smoking.

Background: Beginning in December 2019, the 2019 novel coronavirus disease (COVID-19) has caused a pneumonia epidemic that began in Wuhan, China, and is rapidly spreading throughout the whole world. Nutrition support has become one of the important treatments for severe and critical patients. Objective: To assess the adequacy of nutritional support in COVID-19 patients receiving oxygen support. Methods: A multicenter prospective study enrolled 88 COVID-19 patients receiving oxygen support in Fedail Hospital, Albaraha Hospital, Aliaa Hospital, and Royal Care Hospital during the period from January to April 2021. Data regarding demographics, comorbidities, types of oxygen therapy, vital signs, laboratory investigations, methods of nutrition support, estimated calorie achievement, and outcomes were collected. Nutritional adequacy was assessed by using the Nutritional Risk Screening-2002 (NRS- 2002) test. Results: Among 88 patients, 50(56.8%) were males and 38(43.2%) were females; their mean age was 67±11 years. CPAP (n=28; 32%) and mechanical ventilation (n=27; 27%) were the main types of oxygen therapies. Estimated calories were achieved in only 36(40.9%) of patients and failure to the achievement of estimated calories was commonly due to hypoxia (n=33; 37.5%) and poor appetite (n=23; 26.1%). About 66(75%) patients were adequately nourished, 16(18.2%) were at risk of malnutrition, and 6(6.8%) patients were malnourished. The mortality was significantly associated with malnutrition (P. value= 0.000), and parental feeding modes (P. value= 0.000), and underweighted BMI (mean= 17.8 kg/m2; P. value= 0.000). Moreover, multi-organ failure was significantly correlated with risk of malnutrition (P.value= 0.000), NG feeding (P. value= 0.000) and overweighed BMI (mean= 28.8 kg/m2; P. value= 0.000). Additionally, mortality and multi-organ failure were significantly correlated with hypoalbuminemia among our study subjects (P. value= 0.001). Conclusion: The rates of malnutrition and risk of malnutrition were 6.8% and 18.2% among COVID-19 patients who received oxygen therapy, respectively. Inadequacy of nutritional support or failure in the achievement of estimated calories among our study subjects were commonly due to hypoxia and poor appetite. Mortality was significantly associated with malnutrition, parental feeding modes, and underweighted BMI. Furthermore, multi-organ failure was significantly correlated with the risk of malnutrition, NG feeding, and overweighed BMI. Both, mortality and multi-organ failure were correlated with hypoalbuminemia.

A direct antiglobulin test (DAT) is not routinely used in developing countries including Sudan. The direct antiglobulin test (DAT) is a screening test for antibodies present in an individual’s red cells and is used to diagnose hemolytic disease of the newborn (HDN). The study was to determine the prevalence of DAT among infants at Atbara and Eldamer. The study was designed as a descriptive, cross-sectional study carried out among neonates during January and February 2019 Atbara and Eldamer. ABO group and DAT were carried out among 100 samples of neonatal cord blood. Data were analyzed using SPSS version 22. A total of 100 neonates were recruited for the study. Among 100caces ABO incompatibility status was determined in 74 cases. The higher frequency was (O+, O+)(40%), the lower frequency was (AB+/AB+)(2%) while ABO incompatibility between neonates and mothers was found in 26 (26.0%) cases, The higher frequency of (A/O) incompatibility (15%), the lower frequency was (B+/A+),(AB+/A+)(1%) by the ABO group distribution at the Atbara & Eldamer localities. in this study positive DAT was detected in 2/100 (2.00%) cases (positive DAT was attributed to a typical antibody) two cases are the (O+/O+) group, These two neonates (O RhD positive) and the mothers (O RhD positive), The two cases of alloimmunization were mothers multipara without a history of past transfusions. The study concluded that sensitization with alloantibodies was found among neonatal blood which reflects the importance of detection of allo Abs among cord blood and mothers.

Background: Covid-19 vaccine is an immunization method used to reduce coronavirus incidence but lately caused life-threatening events such as thrombosis with thrombocytopenia syndrome. Methods: This is a case-control study conducted at Shendi town to evaluate platelet parameters and fibrinogen levels in vaccinated healthy individuals With Covid-19 vaccines between Augusts to November 2021. A total of (100) vaccinated healthy individual With the Covid-19 vaccine was enrolled in the study as test groups, compared with (50) healthy volunteers as a control group. Venous blood samples were transferred into Trisodium citrate and EDTA anticoagulant. Data was collected using a questionnaire and the (SPSS) version (22) program was used for data analysis. Results: The study revealed that the vaccinated healthy individuals were; (50%) male and (50%) female. The platelets parameter and fibrinogen indicated the mean values of platelets count, mean platelets volume, platelets distribution width, platelet crit, and fibrinogen, in Janssen vaccine groups, were (251.14 109\L), (8.39 fl), (15.6), (0.203%), and (158 mg\dl) respectively. The results study revealed the mean of PLT, MPV, PDW, PCT, and Fibrinogen, in Astrazeneca vaccine groups, were (272.08 109\L), (8.13fl), (15.56), (0.2211%), (159 mg/dl) respectively. Also explained the mean of PLT, MPV, PDW, PCT and Fibrinogen, in Astrazeneca vaccine groups were (272.08 109\L), (8.13fl), (15.56), (0.2211%), (159 mg\dl) respectively and in Janssen vaccine groups the mean values of PLT, MPV, PDW, PCT, Fibrinogen were ( 251.14 109\L), (8.39fl), (15.63), (0.2034%), (158 mg\dl) respectively. Conclusions: Covid-19 vaccines are responsible for significant changes in fibrinogen level in both AstraZeneca and Janssen vaccine groups.

Background: Hemodialysis (HD) is the most extensively used dialysis method globally, and it necessitates vascular access. Arteriovenous fistulas (AVF), arteriovenous grafts, and central venous catheters (CVC), which can be tunneled or not, are all methods for gaining access. Vascular access is a major risk factor for bacteremia, hospitalization, and mortality among HD patients. The efficacy of Actolind solution in suppressing jugular catheter infection sites in patients with positive jugular catheter culture swab was investigated, as well as the efficiency of Actolind solution opposed to iodine. Methodology: This was a prospective, randomized, comparable efficacy clinical trial completed at the renal unit of the Port Sudan teaching hospital's renal dialysis center. The patient group was recruited from across the Red Sea State. A retrospective study of 50 End Stage Renal Disease (ESRD) patients who were either on upkeep HD or were scheduled to receive a kidney transplant as soon as possible. Sociodemographics, comorbidities, and microbiological growth outcomes were gathered prior to and after the interventional procedure. Results: According to the results, the male to female ratio was 4:1. There were 39 males and 11 females. All of the patients had ESRD, with 10 of them being hypertensive and diabetic, 34 being diabetic solely, and 16 being hypertension exclusively. Gram positive bacteria, gram negative bacteria, and yeasts constituted 32 (64%), 20 (40%), and 6 (12%) of the cultivars, respectively. Seven patients out of fifty had mixed infections (14%). Forty-one wound swab results after intervention were negative, while nine patients had persistent infection confirmed by positive cultures. Conclusion: Removal of CVC due to infection or catheter malfunction occurred less often with Actolind-based lock solutions. We present the prospective comparing Actolind - and iodine -based lock solutions yet. However, due to the retrospective observational nature of this study, conclusions with regard to superiority should be considering.

Background: Ischemic heart disease (IHD), is a group of diseases that includes: stable angina, unstable angina, myocardial infarction, and sudden cardiac death. It is within the cluster of cardiovascular conditions of which it is the multiple expected kinds. Iron is an essential trace element. It has a pivotal role in maintaining various cellular functions and enzyme reactions; whereas, iron overload has been known as a risk factor in the progression of atherosclerosis. Abnormal deposition of iron in the heart cause hemochromatosis and dilated cardiomyopathy and this causes ischemic heart disease. This study aimed to investigate the role of serum iron, serum ferritin, and total iron-binding capacity (TIBC) in the causation of coronary heart disease (CHD) and their relationship with other risk factors of CHD. Methods: This is a cross-sectional case-control prospective analytical study conducted at Al-Mc Nemir University Hospital in Shendi town to evaluate the iron profile in ischaemic heart disease patients in the period between (March 2018—July 2018). The study included (50) patients who were diagnosed with ischaemic heart disease and the study groups were compared with a mean of the normal value. Serum iron, ferritin, and TIBC were estimated by spectrophotometer. Data was collected using a structured face-to-face questionnaire and the (SPSS) version (11.5) program was used for data analysis. Results: The study revealed that the ischaemic heart disease patients were; (40%) male and (60%) female, and the mean age was (57.612 ± 28.24), with a range of (36-65) years distributed as (96%). The study showed that the mean of s. iron was 203.9ug/dl (p.value 0.170), the mean of s. ferritin was 207.6ug/dl(p.value 0.447), the mean of TIBC was 663.0ug/dl( p.value 0.281) when compare with the mean of normal value. No significant difference was found between iron profile and CHD. Serum iron and serum ferritin levels are elevated in patients with CHD when compared with normal values. TIBC levels were lower in patients than normal values. When body iron was analogized with different risk factors (like smoking, hypertension, diabetes mellitus, tobacco, etc) of the condition it was found to be seriously raised. Conclusion: The study concluded that the level of serum iron, ferritin, and TIBC might not be associated with coronary heart disease.

Shivering is one of the most common complications of neuraxial blockade. Some patients find shivering sensation worse than surgical pain post-operatively. Therefore, both prevention and treatment of established shivering should be regarded as clinically relevant interventions during the preoperative period. This prospective experimental study was conducted at Wad Madani Maternity Teaching Hospital and aimed to measure the efficacy of pethidine when used for the treatment of postoperative shivering following spinal anesthesia during the period from November 2018 to February 2019. The sample size included of 40Patients within the American Society of Anesthesia type two physical statuses;25 mg pethidine diluted in 5 ml Normal saline-injected intra veins. All patients were monitored for temperature, heart rate, blood pressure, and oxygen saturation, these parameters were recorded preoperative, and post 10 minutes of operative, then after 10 minutes of pethidine dose administration. Data were analyzed by using a statistical package for social sciences (SPSS). The statistical results showed that there was a significant relationship between hypothermia and the presence of shivering. 90% of cases resolved to shivering, whereas 10% did not resolve, just 2.5% had Nausea and Vomiting and no side effects on the Respiratory and cardiac Systems. Based on those results the study concluded that: a small dose of pethidine 25 mg intra veins is very effective in resolving postoperative shivering with minimum side effects in the gastrointestinal tract and Good Cardiopulmonary stability. The study recommended that: warming tools should be available for patients to prevent heat loss, close monitoring of Patient's temperature intraoperative and in the recovery room, and use of 25mg Pethidine in the Presence of shivering intraoperative or post-spinal anesthesia.

Background: The emergence of antibiotic resistance pathogen is an important health risk, usually gram-negative bacteria acquire resistance to antibiotics by the production of beta-lactamase enzyme, CTX-M-type enzymes are a group of class A extended-spectrum B-lactamases (ESBLs) that are rapidly Spreading among gram-negative worldwide. CTX-M-type ESBLs exhibit powerful activity against cefotaxime and ceftriaxone antibiotics but generally not against ceftazidime, in some geographical areas, CTX-M is now the most prevalent ESBLs in Enterobacteriaceae. There are 172 known variants of CTX-M genes identified until August 25, 2016. Objectives: This present study aims to identify the gene, namely: CTX-M, Responsible for extended-spectrum beta-lactamase (ESBL) among Enterobacteriaceae isolated from different samples of Sudanese patients in Shendi city (urine, pus, and wound). Methodology: 200 samples were identified as gram-negative bacteria. Identification of the isolates was done by using conventional biochemical methods, and ESBLs were screened according to (CLSI) guidelines. ESBLs Positive strains were tested for the presence of ESBL encoding CTX-M, Gene by using PCR with specific primers for the detection of CTX-M. Results: ESBL found to be higher in P. aeruginosa n=18(78.3%) Klebsiella spp n=45 (64.2%). Escherichia coli n=51(57.3%) Proteus n=8(53.3%) the total of ESBL from all gram-negative isolate represent n=122 (61%). The presence of the CTX-M, the gene was confirmed in n=57(46.8%) in all isolates. The CTX-M gene were detected in n= 17 (37.8%) Klebsiella spp, n=28(55%) of Escherichia coli, n=3(37.5%) in Proteus and n=9 (50%) in P. aeruginosa isolates. Conclusion: P. aeruginosa isolates represent a high percentage of ESBL producers followed by Klebsiella spp, then Escherichia coli and proteus spp CTX-M gen detected commonly in Escherichia coli followed by P. aeruginosa then Klebsiella spp and Proteus spp. The study concludes that the ESBL production within gram-negative bacteria was high and the CTX-M gene was spread in Shendi city.

Background: While most people follow social distancing and are avoiding contact with anyone displaying flu-like symptoms, still asymptomatic patients are having positive SAR COV 2 test can transfer disease to others, as well as the outcome of their disease sill not well understood. Objective: To assess the clinical course of asymptomatic COVID-19 patients who had a positive PCR test in multicenter. Methods: This was a prospective cohort multicenter study conducted in the study was conducted in Khartoum State COVID-19 Centres. Namely Alia Hospital, Fedail, and Ministry of Health Laboratories during the period from December 2020 to April 2021. Data was collected using a questionnaire from 98 patients who fulfilled the inclusion criteria. The questionnaire was filled with patients after taking informed consent. Results: The mean age was 49±7.3 years. Males were 58(59.2%) and females were 40(40.8%). The male to female ratio was 1.5:1. The frequency of symptomatic patients' COVID-19 positive test results experience symptoms was 80(81.6%), while the frequency of asymptomatic patients was 18(18.4%). The time and period of appearance of manifestations among COVID 19 patients, the study indicated that among symptomatic patients after PCR test, the moment of appearance of symptoms was 1 – 7 days in 76(95%) and 8 – 14 days after test in 4(5%). After 28 days follow up the outcome of the patients was recovery 76(76.6%), remain Asymptomatic 18(18.4%), and remain symptomatic 4(4.0%). Conclusion: The study demonstrated that the appearance of symptoms before and after the PCR test was significantly affected by chronic diseases as well as chronic medications in use (P. value

Over the last decade, Aryl Hydrocarbon Receptor (AHR) dragged the research community’s attention due to the associated benefits in physiology and pathology. In this study, the probable role of AHR in cancer development is discussed. The ABCG2 gene that regulates uric acid metabolism is controlled by AHR. The study noticed that the failure of AHR control over ABCG2 leads to the accumulation of uric acid, reduction of vitamin D, and hormonal imbalances that are sequentially associated with several types of cancer. Furthermore, the location of AHR in the cytoplasm and its role in the regulation of the development and differentiation of blood cells, makes it impacts on overall cells of the body, while cancer genes can be transmitted through AHR receptors in the placenta to the offspring. Overtiredness of AHR by aging, microbial, chemical, or other environmental factors escalates the risk of cancer cell growth. Consequently, immune system dysfunction is facilitated by metastasis. Meanwhile, the Tryptophan catabolism indicates the exhaustion of AHR. However, this hypothesis lacks experimental exploration for further validation.

Myecetoma is one of the neglected tropical diseases, most prevalent in tropical and subtropical regions in the area known as myecetoma belt. It is caused either by fungi (eumycetes) or bacteria (actinomycetes). We suggest that, through their strong and stable, mycotoxin inhibits pain and aryl hydrocarbon receptor actions and promotes IL-17 release. Furthermore, it affects Catechol-O-methyltransferase (COMT), which is responsible for male sexual orientation and this explains the predominance of myecetoma among men and we suggest that the size of lesion is related to the strength of COMT activity in male patients. Due to the absence of laboratory facilities, we are not able to achieve more than these suggestions, so experimental studies are recommended.

Dithymoquinone is a poorly studied carbonyl polymer of thymoquinone component of black cumin seeds. It suppresses release of histamines and improves clearance of cortisol in the liver and maintains the strength of placental aryl hydrocarbon receptors. Furthermore, we hypothesized that the low percentage of it in black seeds and its slow reduction make it safe for both the mother and her foetus. As many studies suggest, high levels of both histamine and cortisol are associated with preeclampsia, miscarriage, still birth and preterm delivery. We hypothesized that administration of dithymoquinone during pregnancy will prevent pregnancy complications, certainly preeclampsia and maintain the foetus’s life. Experimental research is required to know more about the role of dithymoquinone in maternal and foetal health.

Background: Malaria is a major public health problem throughout human history, particularly in the tropical and subtropical countries. Primaquine, introduced in 1950, for preventing relapse and sterilizes infectious sexual plasmodia. Methods: A retrospective study was performed for 610 patients (250 were male and 360 were female), (all ages) to study the efficacy of Primaquine in the treatment of falciparum malaria after receiving this drug for five days. Results: Five hundred and ninety three patients (97.2 %) were completely recovered from malaria within 3 to 5 days after receiving Primaquine tablets. Conclusion: In our opinion Primaquine should become the first line as antimalarial drug soon later for uncomplicated malaria, because of its high efficiency against infections with Plasmodiumfalciparum and P.vivax active stages.

Stein-Leventhal syndrome (Polycystic ovaries syndrome), represent one of the major obstacles facing reproductive medicine researchers, because there is no information about the etiology of it, and that made them fail to draw smile on faces of millions of women around the world, who are suffering from it. Scientists said that it is attributed to genetic and environmental factors, and we hypothesized that it was caused by environmental pollution by dioxins (specifically heavy metals), which disturb aryl hydrocarbon receptor and that lead to disturbing of nuclear receptors and then express genes which lead to hormonal, metabolic and immunological abnormalities appear in PCOS patients. And fortunately this hypothesis supports our hypothesis about the etiology of COVID-19 and its variants, clinically and epidemiologically. PCOS can be transmitted transmammry, sexually from Dixon exposed male partners, and due to direct exposure to Dixon either via explosion or by excessive use of makeup .Experimental studies is required to test our hypothesis.

Background: Kidney transplantation represents the optimal therapeutic tool for patients affected by end-stage renal disease (ESRD), Candidiasis is a major challenge among renal transplant recipients (RTRs) worldwide and is associated with high morbidity and mortality rates. Fluconazole is the most commonly used agent for Candida infections Aim: to identify Candida spp from renal transplanted patients. Method: cross sectional study were done, 51 Urine sample was collected on sterile urine container then cultured on Sabouraud dextrose agar, incubated at 35 °C and observed daily for 7 days. When the growth of yeast colonies was observed, the Gram stain method was done to verify the absence of bacterial contamination. The yeasts were identified via germ tube test and chromogenic media to differentiate between candida spp. Results: out of 51 patients; female were more than male wit mean age group 45 years for both male and female.The cause of ESRD was; 19 (37.3%) had DM, 12(23.5%) had hypertension, 10(19.6%) had Glomerulonephritis and 3(5.9%) had kidney stone candida species among study group as follow; c.albicans isolated from 28 (54.9%) pt., c.glabrata isolated from 11 (21.6%) pt., c.tropicalis isolated from 6 (11.8%) pt., c.krusie isolated from 3 (5.9%) of pt. and 3(5.9%) had mixed infection. C.albicans, tropicalis and C.krusie had been distributed more among DM groups and less among kidney stone groups, on the other hand C.glabrata more isolated among Glomerulonephritis groups. There was no association between candida species and ESRD. Conclusion: There was no relation between candida spp and cause of ERDS.

The quick spread of COVID-19 crisis and fast emergence of new variants of it , dissimilar clinical forms from silent to exaggerated ones , misunderstanding of etiologies , mode of transmission, variable effectiveness and side effects of vaccines and absence of comprehensive and efficient treatment protocols , heavy spread in certain continents and on less in others a lot of questions arise from the variables mentioned above need answer. In this review I introduced my hypothesis about origin of COVID-19 , its later variants and the main mode of transmission of the virus, the role of mutagenic heavy metals in emergence and the rising of the pandemic and explained the relationship between COVID-19 and malaria. Scattered information used to compose it. Experimental studies are required to test it.

Introduction: Female Anopheles mosquitoes are the exclusive vectors of malaria parasites in Sudan, along with several metazoan parasites such as filarial worms and viruses. The sense of smell is one of the most important senses that mosquitoes use for long-range host-seeking. Carbon dioxide from the breath of humans and animals is a strong attractant of female mosquitoes. Methods: This correlational study was performed in Al-Qaddal Center for Malaria Research in Sinnar State, Sudan. In this study, individual volunteers were topically applied Ocimum bascilicum oil to test its repellency activity. O. bascilicum oil was tested at four different concentrations (30%, 50%, 70%, and 100% v/v), respectively. Results: Based on the obtained results, the oil exhibited the highest repellency activity at 100% concentration, and the average repellency rate was 100%. However, the lowest repellency activity was at 30% concentration, and the average repellency rate was 45%. Diethyltoluamide 13% (Soffell cream) was tested as a reference repellent cream and showed the same effect as O. bascilicum oil at 70% concentration, and the average repellency rate was 94%. Conclusion: The results demonstrated that O. bascilicum oil had high repellency activity against female Anopheles mosquitoes, and thus can be used as mosquito natural repellent.

Introduction: This cross-sectional descriptive study aims to detect the incidence of different types of Malaria in Shendi, Sudan, during the period from November 2019 to February 2020. This study was conducted in Shendi, Sudan, which lies 150 km from the national capital of the Republic of Sudan, Khartoum. Methods: One hundred samples were taken, and the study was conducted in several hospitals in Shendi (Shendi teaching hospital, Almak Nimer hospital, and many laboratories in Shendi). This study examined different types of malaria parasite among the population of Shendi, taking into account the age, gender, residence. A rapid immunochromatographic test and blood film were used to diagnose the incidence of Plasmodium falciparum compared to the other types of Plasmodium. Results: On blood film test, 98% of already diagnosed cases of malaria by microscope were positive, and only 2% were negative; furthermore, 96 % of malaria cases were caused by P. falciparum, and only 2 % were caused by Plasmodium vivax. Conclusion: The present study concluded that the incidence of malaria was high in the study area. More than two-thirds of patients diagnosed with malaria in Shendi in 2019-2020 were young aged 15-30 years, and more than half of the cases were female. Blood film examination is the gold standard for malaria diagnosis. P. falciparum was responsible for 96% of cases, and the other species were much less common.

Malaria is most prevalent parasitic disease, it caused by coccidian parasite of the genus plasmodium, four species are usually infect human beings, P. falciparum, P. vivax, P. malriae and P. ovale, Most of malaria cases resulted from P. falciparum and P. vivax. Aryl hydrocarbon receptor (AHR) is an environmental sensor exists in many parts of human body such as lung, spleen, gut and breast. In this review we discussed the functions of it as regulator for proinflammatory and anti-inflammatory cytokines, the possible role of diet during pregnancy and breastfeeding in boosting immunity against malaria during pregnancy and childhood by triggering AHR. Also we hypothesize that probable role of it in synchronizing erythrocytic schizogongy. Experimental studies recommended to know more about the biological protective functions of AHR.

Medicinal plants, recognized and employed in conventional medicine practices since prehistoric era. Plants produce thousands of chemical substances for functions counting defence against insects, fungi, bacterial and parasitic diseases. Malaria is most widespread parasitic infection , it caused by coccidian protozoa of the genus plasmodium , four species are mostly infect human, P. falciparum, P. vivax, P. malriae and P. ovale, Majority of malaria cases resulted from P. falciparum and P. vivax. Uric acid regarded as one of the damaging molecular patterns of malaria parasite infection, and in this review we discussed the potential role of medicinal plants used as antimalarial to diminish the level of uric acid in gout patients. These may suggest that most of the complication associated with malaria, may attributed to amplified level of uric acid . Experimental studies recommended.

Both malaria and leishmania are most widespread protozoon parasitic diseases, certainly in tropical countries of the world. Malaria leishmania coinfection is common in leishmaniasis endemic areas which is mostly endemic to malaria too. Researchers notice that in cases of malaria leishmania coinfection , leishmania species find the some extent the outcome of malaria infection , but also behavior of malaria parasite species play a significant role to figure the consequences of it. While L. donovani protect from severe malaria complications by suppression of major histocompatibility class Ⅱ , so it diminish the clinical severity of malaria but not malaria parasite density due to dysfunction of major histocompatibility class I, which controlled by suppressed one, In another side L. mexicana tends to sequester in macrophages and lead to severe clinical outcomes when it coexisted with malaria parasite at same host. Experimental studies required to know more information about coinfection of different malaria and leishmania species to establish clinical research. Leishmania infection excluded when studies aim to assess the immune response to only malaria parasite, experimental studies required involving different species of malaria and leishmania.

Background: Caffeine is a significant component of coffee, which is one of the most extensively, consumed non-alcoholic beverages. Caffeine is a methylxanthine-class central nervous system stimulant that is one of the most extensively utilized medications on the planet. Caffeine stimulates the central nervous system and is perhaps the most extensively used psychoactive stimulant. It causes gastrointestinal disturbances, tremor, headache, and sleeplessness, palpitations, cardiac arrhythmias, and it has been proposed that caffeine is possibly hypertensive. Aim: The goal of the study was to see how caffeine affected the blood pressure of Sudanese adult females in Gezira state's east during July and August 2018. Methods: A descriptive cross-sectional prospective study of 400 females aged 18 to 70 years old from various areas of Gezira State was conducted. Caffeine was not consumed by the participants for 12 hours before to the test. Blood pressure was monitored at baseline after 20 minutes of rest, then 45 minutes later after consuming a 150 mL cup of boiling coffee (120 mg caffeine) (each cup contain teaspoon 10 g of coffee powder). A questionnaire was created to collect personal and demographic information. Body mass index (BMI) was computed after measuring weight and height. Results: The researchers discovered that 120 mg of caffeine increased systolic blood pressure by 5 to 18 mmHg, diastolic blood pressure by 6 to 16 mmHg, and mean blood pressure by 3 to 13 mmHg. Caffeine had a higher effect in older and hypertensive people, according to the study, with a P value of