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Shukri Said Mohamed,1 Adem Küçük,2 Omar Adam Sheikh,3 Ahmet SARAÇ,4 Mesut Kayse Adam,1 Ismail Gedi Ibrahim,5 Marian Muse Osman,6 Naima Abukar Ali,7 Abdirahman Ahmed Mohamud8 1Department of Pediatric Surgery, Mogadishu Somali Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia; 2Düzce Atatürk Devlet Hastanesi, Düzce, Turkey; 3Faculty of Medicine, Department of Basic Medical Science, Somali National University, Mogadishu, Somalia; 4Department of Pediatric Surgery, Samsun Training and Research Hospital, Samsung, Turkey; 5Department of Radiology, Mogadishu Somali Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia; 6Department of Public Health, Mogadishu Somali Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia; 7Department of Pediatric, Mogadishu Somali Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, Somalia; 8Department of General Surgery, Mogadishu Somali Turkey Recep Tayyip Erdoğan Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Shukri Said Mohamed, Email sagalsaid2@gmail.comBackground: Birth defects of the digestive system are a phenotypically and etiologically different category common birth defects caused by various causes during fetal development.Objective: The study’s goal was to evaluate patient demographics, related abnormalities, atresia location, operational management, postoperative care, and results of patients with gastrointestinal atresia and compare them with other research.Methods: A 5-year retrospective study in cases with gastrointestinal atresia at a tertiary hospital in Mogadishu, Somalia, was carried out by the pediatric surgery department from January 2017 to January 2022.Results: A165 cases were operated due to gastrointestinal atresia in five-year period., 105 were male (63.6%) and 60 were female (36.4%), giving the male to female ratio of 1.75:1. According to the age group of the study population, the majority of cases (48.5%) were aged less than 1 month. The esophageal atresia, duodenal atresia, high jejunal atresia, jejunoileal atresia, and colon atresia, anorectal malformations were 9.7%, 9.1%, 0.6%, 7.3%, 73.3%, respectively; the anorectal malformations has resulted in the majority of cases (73.3%). 20 % of cases had no follow-up, while 80% arrived as planned. 52.1% got well and had no complications and some developed different complications like peristomal skin irritation (14%), rectal and urethral fistula (4.8%), rectal prolapse (1.8%), rectal stenosis (2.4%), rectal adhesions (1.2%), esophageal stricture (1.2%), wound infection (3.6%), anastomosis dehiscence (0.6%), abdominal distension (0.6%), recto-perineal fistula (1.2%), urethral damage and urinary retention (0.6%). Mortality for this study was 24.8% (41 patients).Conclusion: Children with gastrointestinal atresia present late in the course of their illness, with substantial morbidity and death due to poor economic conditions, poor nutrition, surgical problems, and likely related anomalies, rather than surgical morbidity alone.Keywords: birth defects, fetal development, digestive system, intestinal obstruction

Nasteho Mohamed Sheikh Omar,1 Marian Muse Osman,2 Ifrah Adan Hilowle,3 Betul Erismis,4 Abdirahman Abdikadir Osman,5 Osman Abubakar Fiidow,6 Ahmed Muhammad Bashir5 1Department of Emergency Medicine, Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia; 2Department of Public Health, Mogadishu Somali Turkey Training and Research Hospital, University of Health Sciences, Mogadishu, Somalia; 3Department of Education, Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia; 4Department of Internal Medicine, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey; 5Department of Internal Medicine, Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia; 6School of Public Health and Research, Somali National University, Mogadishu, SomaliaCorrespondence: Ahmed Muhammad Bashir, Department of Internal Medicine, Mogadishu Somali Turkey Training and Research Hospital, Mogadishu, Somalia, Email ambashir@hotmail.comBackground and Aim: Although postpartum acute kidney injury (PPAKI) is declining in developing countries, it is still a leading cause of maternal and fetal morbidity and mortality. The study aimed to determine the causes, risk factors, and the outcomes of patients with postpartum acute kidney injury managed at Mogadishu Somali Turkey Training and Research Hospital, in Mogadishu, Somalia over a two years period.Methods: This study was conducted retrospectively at Mogadishu Somali-Turkey Training and Research Hospital, Somalia’s largest teaching and referral hospital. During a two-year period (January 2020 to December 2021), we evaluated women who had acute kidney injury during the postpartum period and were hospitalized in our hospital. The data was also evaluated for postpartum admission day and hospital stay. The requirement for dialysis and the results were documented. Maternal outcomes are categorized as follows: Complete recovery after discharge/follow-up, chronic dependence on hemodialysis and death during admission.Results: We studied 79 postpartum AKI patients. The mean age of the participants was 28.67 ± 6.14. Most patients (51%) were aged 20– 30, followed by 30– 40 (29%). According to self-reported comorbidities, most individuals had no history of chronic diseases, 8 (10.1%) had hypertension and 3 (3.8%) had heart failure, and DM and HTN 2(2.5%). The most common causes of PPAKI were eclampsia (24.1%), hemorrhagic shock, intrauterine mortality (16.5%), placenta abruptio and uterine rupture (8.9%). Hemorrhage (5.1%) and placenta previa (2.5%). The patient’s outcome was associated with age (p=0.04), platelet (p=0.024), and hospital stay (p=0.009).Conclusion: Postpartum acute kidney injury is very common in underdeveloped nations. Preeclampsia/Eclampsia, obstetric bleeding, and intrauterine death are the leading causes of postpartum acute kidney injury in Somalia. This tragic scenario may be avoided by providing appropriate antenatal care and raising awareness among Somali women about the benefits of antenatal care provided by public institutions.Keywords: postpartum AKI, pregnancy-related acute kidney injury, Somalia, eclampsia

The problem of drug addiction in Singapore has been relatively under control over the past few years. This is a result of the strategy of controlling supply to reduce demand for drugs. Alcohol consumption in Singapore is relatively low compared to Western countries. This paper provides an overview of the drug and alcohol control and treatment strategies adopted in Singapore. While new strategies have been formulated, some issues and challenges still remain. These issues and challenges are discussed and findings of a recent study conducted by the author are described. They include the need to focus on gateway drugs like alcohol, intervention involving family members, opportunities for regular employment for drug addicts, and the role of religion in aftercare treatment. [ABSTRACT FROM AUTHOR]

The kidney is considered the main site for the net release of Tyrosine (Tyr) to the circulation through hydroxylation of Phenylalanine (Phe) using phenylalanine hydroxylase enzyme. In chronic kidney disease (CKD) patients the enzyme activity is impaired, therefore the serum concentration ratio of Tyr/Phe is reduced compared to healthy individuals. This motivates us to develop a cost effective, green, simple, sensitive, and selective HPTLC method to measure the levels of Tyr and Phe in serum samples. The analysis was carried out using acetonitrile: ethanol: 25% ammonia solution: ethyl acetate (6.5: 1.5: 1: 0.5) as a mobile phase. Rf values were 0.55 ± 0.05 for Phe and 0.39 ± 0.05 for Tyr. Densitometry scanning was performed using UV detector and dual wavelengths of 210 and 225 nm were obtained. A linear correlation was observed between the levels of Phe and Tyr, ranging from 50 to 700 ng band - 1 and 50 to 600 ng band - 1 , respectively, under the optimum conditions. The method selectivity, linearity, precision, accuracy, and robustness were all confirmed in accordance with ICH recommendations. Calculations of the separation and resolution factors, number of theoretical plates, and height equivalent to theoretical plates prove to the chromatographic system accuracy and high separation efficiency. The developed method exhibits an acceptable eco-scale when measuring the method greenness using AGREE and GAPI softwares. It was applied for the determination of Phe and Tyr concentrations in human serum samples., Competing Interests: Declarations Competing interests The authors declare no competing interests. Ethics approval and consent to participate Approval for the experimental protocols was granted by the Institutional Ethics Committee at the Faculty of Medicine, Assiut University (IRB approval no: 04-2023-200151), which ensures compliance with the guidelines for the appropriate care and use of laboratory animals., (© 2024. The Author(s).)

Monkeypox virus (MPXV) is endemic in western and Central Africa, and in May 2022, a clade IIb lineage (B.1) caused a global outbreak outside Africa, resulting in its detection in 116 countries and territories. To understand the global phylogenetics of MPXV, we analyzed all available MPXV sequences, including 10,670 sequences from 65 countries collected between 1958 and 2024. Our analysis reveals high mobility of clade I viruses within Central Africa, sustained human-to-human transmission of clade IIb lineage A viruses within the Eastern Mediterranean region and distinct mutational signatures that can distinguish sustained human-to-human from animal-to-animal transmission. Moreover, distinct clade I sequences from Sudan suggest local MPXV circulation in areas of eastern Africa over the past four decades. Our study underscores the importance of genomic surveillance in tracking spatiotemporal dynamics of MXPV clades and the need to strengthen such surveillance, including in some parts of eastern Africa., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

We evaluated the incidence and potential etiology of tracheobronchial uptake in patients being evaluated by 18 F-DCFPyL PET/CT for prostate cancer (PCa). Methods: The study included a consecutive 100 PCa patients referred for 18 F-DCFPyL PET/CT. The PET/CT scans were retrospectively reviewed. The presence or absence of physiologic tracheobronchial uptake on PET/CT was recorded. To further evaluate tracheal prostate-specific membrane antigen (PSMA) expression, immunohistochemistry was performed on tracheal samples taken from 2 men who had surgical resection of lung cancer. Results: Tracheal uptake was present in 31 of 100 patients (31%). When tracheal uptake was present, the SUV max was significantly higher in the left main bronchus (mean, 2.7) than in the right (mean, 2.3) ( P < 0.001). Histopathologic testing of tracheobronchial samples showed PSMA expression in bronchial submucosal glands. Conclusion: In PCa patients undergoing 18 F-DCFPyL PET/CT, tracheobronchial uptake occurred in 31% of patients. This is attributed to normal physiologic PSMA expression in bronchial submucosal glands., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)

Background: One of the core indicators recommended by the Lancet Commission is surgical workforce density, aiming to improve the number of surgery, anesthetists, and obstetric (SAO) providers to 20 per 100,000 population by 2030. We assessed SAO workforce capacity in Somalia and made recommendations for improvement., Method: A cross-sectional study was conducted using a structured questionnaire from the WHO Program for Global Surgery and Social Change (PGSSC) Surgical Assessment Tool. All hospitals that offer surgical care services were included. A descriptive analysis was conducted using the statistical software SPSS., Results: Of the 55 surveyed facilities providing surgical care services, 28 (50.9%) were public, mainly in urban areas. We found that there were 474 SAO specialists and non-specialists (SAO providers) and 446 other important personnel (e.g., midwives, radiologists, and pathologists). Out of 474 SAOs, Banadir had 288. Overall, surgery specialties were the most prevalent profession among SAO providers' workforce, accounting for 160 (33.7%) surgery specialists, with 1.2 per 100,000 population. The six states of Somalia have 54 OB/GYN specialists (0.4 per 100,000 population). There were a total of 22 anesthesia specialists, with a ratio of 0.2 anesthesia specialists per 100,000 population., Conclusion: We found a serious shortage of the SAO workforce in Somalia, and it is unlikely to meet the 2030 Lancet Commission on Global Surgery targets. There is a need for additional training of SAO providers who can offer effective leadership in surgical care services to combat the extremely avoidable surgical-related morbidities and mortalities., (© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).)

Background: Researchers have investigated different techniques for synthesis of carbon dots. These techniques include Arc discharge, laser ablation, oxidation, water/solvothermal, and chemical vapor deposition. However, these techniques suffer from some limitations like the utilization of gaseous charged particles, high current, high temperature, potent oxidizing agents, non-environmentally friendly carbon sources, and the generation of uneven particle size. Therefore, there was a significant demand for the adoption of a new technology that combines the environmentally friendly aspects of both bio-based carbon sourcing and synthesis technique., Results: Medicago sativa L (alfalfa)-derived N, S-CDs have been successfully synthesized via microwave irradiation. The N,S-CDs exhibit strong fluorescence (λ ex/em of 320/420 nm) with fluorescence quantum yield of 2.2 % and high-water solubility. The produced N,S-CDs were characterized using TEM, EDX, Zeta potential analysis, IR, UV-Visible, and fluorescence spectroscopy. The average diameter of the produced N, S-CDs was 4.01 ± 1.2 nm, and the Zeta potential was -24.5 ± 6.63 mv. The stability of the produced nano sensors was also confirmed over wide pH range, long time, and in presence of different ions. The synthesized N, S-CDs were employed to quantify the antibacterial drug, nifuroxazide (NFZ), by fluorescence quenching via inner filter effect mechanism. The method was linear with NFZ concentration ranging from 1.0 to 30.0 μM. LOD and LOQ were 0.16 and 0.49 μM, respectively. The method was applied to quantify NFZ in simulated gastric juice (SGJ) with % recovery 99.59 ± 1.4 in addition to pharmaceutical dosage forms with % recovery 98.75 ± 0.61 for Antinal Capsules® and 100.63 ± 1.54 for Antinal suspension®. The Method validation was performed in compliance with the criteria outlined by ICH., Significance and Novelty: The suggested approach primarily centers on the first-time use of alfalfa, an ecologically sustainable source of dopped-CDs, and a cost-effective synthesis technique via microwave irradiation, which is characterized by low energy consumption, minimized reaction time, and the ability to control the size of the produced CDs. This is in line with the growing global recognition of the implementation of green analytical chemistry principles., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: Children living in conflict zones plagued with adverse climatic conditions often suffer from acute malnutrition. Being coinfected with intestinal parasites could worsen the prognosis if adequate interventions are not promptly instituted. We determined the pattern of intestinal parasitic infections (IPIs) in children with acute malnutrition in the Bay and Banadir regions of Somalia., Methods: A hospital-based cross-sectional study was conducted from August to October 2023 in 222 children with acute malnutrition aged 6-59 months, using a structured questionnaire and stool examination by a trained laboratorian. The prevalence of IPI was estimated and the pattern of IPI was explored. The relationship between the presence of IPI and demographic characteristics was examined with multiple logistic regression at a 95% level of confidence., Results: The mean age was 20.4 ± 12.3 months, 125 (56.3%) were females, and 41.9% were internally displaced. The prevalence of IPI was 82.9% (95% confidence interval: 77.4-87.3), Of the infected, 73.9% (136 of 184) had single parasitic infection and 23.4% (43 of 184) had double parasitic infections. Ascaris lumbricoides (46.6%), Giardia lamblia (22.1%), and Entamoeba histolytica (17.6%) were the most common parasites identified. The age of 13-36 months (adjusted odds ratio: 1.13, P = 0.02) and eating once a day (adjusted odds ratio: 1.13, P = 0.06) were associated with being infected with intestinal parasites., Conclusions: The prevalence of intestinal parasitic infection was high in children with malnutrition in the Bay and Banadir regions. Deworming should be extended to all children with malnutrition. Food, sanitation, and water provision initiatives should be improved at the community level., Competing Interests: The authors have no competing interests to declare.

Background: According to the National Comprehensive Cancer Network Guidelines, 18F-fluciclovine PET/CT is considered appropriate after negative standard of care (SOC) imaging., Objective: To prospectively compare 18F-fluciclovine to SOC imaging, investigate whether it should be done when SOC imaging is (+), and evaluate its detection rate in patients receiving androgen deprivation therapy., Methods: We recruited 57 prostate cancer patients with biochemical recurrence with 18F-fluciclovine PET/CT and SOC imaging within 30 days. Prostate-specific antigen (PSA) level, Gleason score (GS), history of radical prostatectomy (RP), radiation therapy (RT) or hormone therapy (HT) were reviewed., Results: The 57 patients had a median PSA of 2.6 and average GS of 7.4; 27 (47.4%) had RP, 28 (49.1%) had RT, 1 (1.75%) had HT and 1 (1.75%) observation only. 18F-fluciclovine identified disease recurrence in 45/57 patients (78.9%), including oligometastasis in 18/45 (40%). SOC imaging identified recurrent disease in 12/57 patients (21.1%) while 18F-fluciclvoine identified additional sites of disease in 11/12 (91.7%). The (+) 18F-fluciclovine studies had a median PSA 2.6 ng/ml compared to 6.0 ng/ml in the (+) SOC studies., Conclusion: 18F-fluciclovine was superior to SOC imaging for lesion detection, identification of oligometastasis and identification of additional sites of disease., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The objective of this study was to identify the factors associated with anemia among pregnant women attending a tertiary referral hospital in Mogadishu, Somalia., Methods: An unmatched case-control study was conducted on pregnant women who visited the antenatal clinics of a tertiary referral hospital between March and July 2021. The study recruited pregnant women who had a hemoglobin level of <11 g/dL into the anemic group, while those with hemoglobin levels ≥11 g/dL were included in the non-anemic group. Demographics, clinical, obstetrics, nutrition-related, hygiene- and sanitation-related, and parasitic infection-related data were collected., Results: A total of 449 pregnant women (399 anemic and 50 non-anemic) participated in the study. A total of 224 (56.7%) in the anemic group and 31 (62.0%) in the non-anemic group did not consume any dark green, leafy vegetables such as spinach, bukurey, cagaar, and koomboow (p=0.040). Notably, 255 (63.9%) in the anemic group and 21 (42.0%) in the non-anemic group had a middle-upper arm circumference <23 cm. More than half of anemic [335 (84%)] and non-anemic [46 (92.0%)] were classified under low dietary diversity score. Majority of the study participants, 288 (72.4%) of the anemic and 39 (78%) of the non-anemic groups, used pit toilets in dwellings, and 70.2% (134/191) of the anemic and 64.4% (246/382) of the non-anemic groups disposed of solid waste in open fields., Conclusion: This study demonstrated that women who consumed green vegetables such as spinach, bukurey, cagaar, and koomboow in their diet had middle-upper arm circumference less than 23 cm, and those with low dietary diversity significantly developed anemia during pregnancy.

Background: Vitiligo is an immune-mediated, chronic skin condition that affects both the innate and adaptive immune systems. Antimicrobial peptide overexpression is one of its defining characteristics. Granulysin (GNLY), an antimicrobial peptide, may play a role in the pathogenesis of various autoimmune diseases., Objectives: To estimate the serum GNLY levels in vitiligo patients and to correlate those levels with the severity and activity of the disease., Materials and Methods: This case-control study included 60 non-segmental vitiligo patients (Group A) and a control group of 60 people who were matched for age and sex, appeared to be in good health, and were not suffering from vitiligo (Group B). The serum granulysin levels of all subjects were measured using an enzyme-linked immunosorbent assay., Results: When compared to the control group, vitiligo patients had significantly higher serum GNLY levels ( P = 0.001). When compared to patients with stable disease, those with active vitiligo had significantly higher serum GNLY levels ( P = 0.008). Additionally, there was a positive correlation between the serum GNLY levels and the vitiligo area severity index and vitiligo disease activity scores ( P = 0.004 and <0.001, respectively)., Limitations: Study population was relatively small. Evaluation of serum granulysin before and after treatment could have been more beneficial., Conclusions: Blood granulysin levels could contribute to the pathogenesis of vitiligo. A higher serum granulysin level may also be a trustworthy predictor of the severity and progression of a disease., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Dermatology Online Journal.)

Background: Dengue has become an alarming global problem and is endemic in many countries, particularly in tropical and subtropical countries. The aim of this study was to investigate dengue fever outbreak in Banadir Region, Somalia, to understand the risk factors (time, place, personal characteristics)., Methods: A descriptive cross-sectional study was undertaken to determine the levels of circulating anti-dengue virus antibodies and DENV NS1 antigen among Banadir Region residents, while a questionnaire survey was conducted to understand the clinical and demographic characteristics of the patients., Results: A total of 735 febrile patients were studied, with 55.6% men and 44.3% women. The majority of the participants were children aged 14 years and younger. Among them, 10.8% tested positive for IgM antibodies against dengue virus (DENV), while the prevalence of DENV NS1 antigen was 11.8%. Fever and myalgia were the most common symptoms observed in the DENV-positive patients., Conclusions: A dengue fever outbreak has been confirmed in Banadir region, Somalia. This study provides information on the most affected districts and identifies risk factors contributing to DF outbreaks. The study recommends improving outbreak readiness and response, particularly in surveillance and laboratory diagnostics, by fostering intersectoral collaboration and establishing regulatory frameworks for financial and operational participation., (© 2024. The Author(s).)

Background: Following the World Health Organization declaration, COVID-19 was first appearance in Sudan was in March 2020. Cases were reported to the Sudan Federal Ministry of Heath through the surveillance system from different sources. This study used surveillance data from 2020 to 2021 to describe the epidemiologic patterns of COVID-19 occurrence in Sudan and provide insight for better preparedness and response., Methods: Through a retrospective descriptive study, COVID19 cases records obtained from the national surveillance line-list in Surveillance and Information Directorate in Federal Ministry of Health. The analysis of data was done with SPSS version 21. Descriptive analysis done by frequencies and percentages, and further analysis through performing multivariate logistic regression., Results: Out of 48,545 suspected cases tested for COVID-19 using RT-PCR, 27,453 (56.5%) tested positive with case fatality ratio of 6.5%. Higher death rate among elderly (78% > 60-year-old) and males (70.1%). From the reported cases, 53.8% showed no symptoms, while the common symptoms among symptomatic patients were; fever (26.4%), cough (19.1%), shortness of breath (16.8%) with small proportion (4.5%) reported loss of smell and taste. Specific states, Khartoum, Gezira and Red Sea showed highest prevalence. The disease peaked four times during 2020-2021, with a proposed alert threshold of 200-250 cases per week acting as an explosion point nationwide., Conclusions: The high case fatality rate in the country requires further analysis, as well as the high proportion of asymptomatic infection. This will be ensured by improving the quality and completeness of surveillance data. A proposed threshold of 200-250 cases per week should be an alert to augment the measures of controlling the pandemic over the country, including providing enough supplies to decrease mortality., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 Published by Elsevier Ltd.)

Background: To-date there have been minimal studies to investigate an association between the gut microbiome and erectile dysfunction. There have been many inflammatory diseases linked to gut microbiome dysbiosis; such as cardiovascular disease and metabolic syndrome. These same inflammatory diseases have been heavily linked to erectile dysfunction. Given the correlations between both conditions and cardiovascular disease and the metabolic syndrome, we believe that it is worthwhile to investigate a link between the two., Objective: To investigate the potential association between the gut microbiome and erectile dysfunction., Methods: Stool samples were collected from 28 participants with erectile dysfunction and 32 age-matched controls. Metatranscriptome sequencing was used to analyze the samples., Results: No significant differences were found in the gut microbiome characteristics, including Kyoto Encyclopedia of Genes and Genomes richness (p = 0.117), Kyoto Encyclopedia of Genes and Genomes diversity (p = 0.323), species richness (p = 0.364), and species diversity (p = 0.300), between the erectile dysfunction and control groups., Discussion: The association of gut microbiome dysbiosis and pro-inflammatory conditions has been well studied and further literature continues to add to this evidence. Our main limitation for this study was our small-sample size due to recruitment issues. We believe that a study with a larger population size may find an association between the gut microbiome and erectile dysfunction., Conclusions: The results of this study do not support a significant association between the gut microbiome and erectile dysfunction. Further research is needed to fully understand the relationship between these two conditions., (© 2023 The Authors. Andrology published by Wiley Periodicals LLC on behalf of American Society of Andrology and European Academy of Andrology.)

Background: Female Genital Mutilation (FGM) is defined as any procedure that involves damage to the female external genitalia. This practice is majorly prevalent in Sudan, as it is estimated that over 12 million Sudanese women are circumcised. This study uncovers rural females' knowledge and insights about FGM domestically., Methods: A qualitative, deductive study with thematic analysis was conducted. A total of 42 female high school students were recruited and divided into five focus groups, each of which included girls from four different high school classes in the main school of the study area. A topic guide was prepared and used to lead the focus groups. Thematic analysis was used, and the study data had been categorized into four themes: knowledge, procedure and performance, experience, and practice. The condensed meaning units of each theme were identified, then classified to formulate sub-themes., Results: All the participants indicated that FGM is a traditional practice in the village. The vast majority have heard about it from family members, mainly mothers and grandmothers. Regarding the procedure, all the participants agreed that midwives perform FGM, but most of them don't know what exactly is being removed. According to all participants, mothers and grandmothers are the decision-makers for FGM. The majority of the participants stated that they do not discriminate between the circumcised and uncircumcised women and most of them agreed that circumcision has negative side effects. They have mentioned pain, difficult urination, and walking as early side effects, while psychological impacts and labor obstruction as late ones. Generally, the majority of the participants agreed that circumcision is not beneficial and should stop., Conclusion: Knowledge regarding the dangers of FGM among high school girls is better than expected given the high prevalence of the practice. Generally, the process is well understood, the performers are known, the experience is universal, and the side effects are acknowledged. Nevertheless, a majority still showed an intent to circumcise their daughters in the future., (© 2023. The Author(s).)

Objective: Data regarding the imbalance in follicular helper T (Tfh) and follicular regulatory T (Tfr) cell responses in patients having chronic rhinosinusitis with nasal polyps (CRSwNP) is so far limited. Thus, we aimed to assess the changes in circulating Tfh and Tfr in CRSwNP patients., Methods: This case-control study included 21 patients having CRSwNP and 20 age and sex-matched healthy blood donors as a control group. Lund-Mackay staging system was used for radiologic scoring of chronic rhinosinusitis. Two milliliters of peripheral blood samples were collected from all participants into EDTA-containing vacutainer tubes to assess the levels of Tfh and Tfr cells using flow cytometry., Results: Patients having CRSwNP did not show significant differences in the percentages of CD4+ T cells and total CD4+CXCR5+ T cells from healthy controls. Meanwhile, levels of both activated circulating Tfh and Tfr showed a marked rise in patients than controls. In addition, a positive correlation was observed between the levels of both activated Tfh and Tfr cells., Conclusion: An imbalance in circulating Tfh/Tfr levels was detected in patients having CRSwNP. A significant rise in the levels of Tfh and Tfr was detected in patients proposing a possible role of this imbalance in disease pathogenesis.

Background: With students becoming more involved in the internet and social networking sites, they become more prone to their consequences. This study focuses on measuring the social networking intensity and the fear of missing out among the medical students of University of Khartoum, then examining the association between them., Methods: Facility-based, descriptive, cross-sectional study was conducted at Faculty of Medicine, Khartoum University between January and March 2021. A total of 333 students were selected by simple random sampling. Data was collected from the participants using a structured self-administered questionnaire that involved the social networking intensity (SNI) scale and fear of missing out (FOMO) scale. The data was analyzed by the Statistical Package for Social Science (SPSS) software version 26., Results: Moderate positive correlation between social networking intensity and fear of missing out was found (p-value < 0.01). Of the total participants; 51 participants (15.4%) experienced low SNI and low FOMO. Another 78 participants (23.6%) had moderate SNI and moderate FOMO and only 16 Participants (4.8%) showed high SNI and high FOMO. There were no significant differences in SNI or FOMO scores among the different socio-demographic variables, except for the SNI score which was positively correlated to the monthly income., Conclusion: An association between SNI and FOMO was found. SNI was not affected by socio-demographic factors except for the monthly income., (© 2023. The Author(s).)

Objectives: This study aimed to identify associated factors for postpartum depression (PPD) among women with female genital mutilation (FGM) in Somalia., Methods: This was a cross-sectional study conducted between February and May 2021 in Somalia Mogadishu-Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia. Mothers with any known chronic disease, or psychiatric disorders and who refused to participate were excluded from the study. The cutoff point for depression was defined as ≥13 points according to the Edinburgh Postnatal Depression Scale., Results: Out of 446 postpartum mothers, 267 (59.9%) had increased depressive symptoms in the early postpartum period. PPD scale scores of mothers who were very poor were significantly higher depression scores than their counterparts ( p  = .002). Education level, place of residence, occupational status, number of children, type of FGM, and the presence of perineal tear did not differ significantly between depressed and non-depressed groups., Conclusions: Women with FGM had increased depressive symptoms in the early postpartum period in Somalia. In addition, women who had lower income had higher PPD scores than their counterparts. Further studies are needed to develop a deeper understanding of the relationships between FGM and PPD and its causes.

Background: Children and young adults have a vast array of electronics at their fingertips. While it can provide endless hours of entertainment and education, we are also seeing a structural consequence. Children are using these devices with their head tilted down with poor posture resulting in increased stress on the skull from attached structures which can lead to a bone spur (exostosis) at the external occipital protuberance (EOP). While typically painless, it can progress to necessitate surgical intervention., Objectives: The purpose of this study is to understand the prevalence of exostosis at the EOP and how the finding can affect the nuclear medicine bone scan., Materials and Methods: 43 pediatric patients who underwent a whole-body bone scan over a period of 1 year were included in the study (10-19 years old). Images were reviewed by 2 board-certified Nuclear Medicine physicians to assess for uptake midline in the occipital skull. Suspected cases were followed up with all available clinical and radiographic reports and images., Results: Bone scan demonstrated an occipital focus of uptake in 7 (16%) of the 43 patients (5 males and 2 females with a mean age of 15 years; range 10-19). Of these, 5/7 (71%) were confirmed by additional imaging., Conclusion: The rapidly advancing technology is leading to increased screen time in children and young adults. Our study shows that 16% of the pediatric population imaged at our facility between the ages of 10-19 years have signs of exostosis at the EOP. It is particularly important for clinicians to be aware of this entity when reading bone scans to avoid false positive interpretations., Competing Interests: None., (AJNMMI Copyright © 2023.)

Objectives: Hashimoto's thyroiditis (HT) is the most common cause of hypothyroidism. The exact mechanism initiating the development of HT is not yet clear. This study aimed to investigate the correlation between HT and the presence of Epstein-Barr virus (EBV) in a Sudanese population., Results: EBV-LMP1 was detected in 11.1% of HT cases, which is consistent with previous studies. Studies have reported a wide range of frequencies indicating the presence of EBV in HT, and patients with autoimmune thyroiditis have increased titers of anti-EBV antibodies in their sera compared to healthy subjects. Intrathyroidal EBV-infected B cells may be responsible for the increased risk of development of B-cell lymphoma in the thyroid gland in patients with autoimmune thyroiditis. Our study suggests that regular follow-up is necessary for patients diagnosed with HT and are positive for EBV, as antiviral therapy is not applicable due to the risk of thyroid dysfunction. The study suggests an association between EBV and HT, but causation cannot be determined. The study also highlights the need for further research to determine the viral role and correlate it with the severity and progression of HT., (© 2023. BioMed Central Ltd., part of Springer Nature.)

The International Consensus Classification (ICC) and World Health Organization (WHO) proposed significant changes to the diagnostic criteria of myelodysplastic syndromes (MDS) in 2022. The impact of these criteria on hematopathology practice is uncertain. This study aims to evaluate the impact of the 2022 ICC and WHO 5th edition classifications on the diagnosis of cytopenias and MDS. Cases from 2021 performed for primary diagnosis of cytopenia(s)/MDS and their clinical, laboratory, and pathologic findings were reviewed and classified according to the new classification systems. The rate of major changes to the diagnosis was determined and potential pitfalls in the diagnostic approach, laboratory workflow, and clinical communication challenges were investigated. A total of 49 cases were recruited. Major changes to the diagnostic entities were made in 18/49 (37%) cases according to the WHO 5th edition, and 23/49 (47%) cases classified according to the ICC. The difference was accounted for by five cases of MDS-EB2 (revised WHO 4th edition) classified as MDS/AML (major change) in the ICC in contrast to no significant change (MDS-IB2) in the WHO 5th edition. MDS-SLD cases were not subject to major reclassification according to either system. The new molecularly defined categories of CCUS/CHIP, MDS-SF3B1, and MDS with biallelic TP53 mutations were almost identically represented in both systems in our cohort. A case of MDS-MLD was reclassified as CMML by both classification systems. There are few but important differences between the new MDS classification systems. A preimplementation assessment is helpful to identify diagnostic and potential clinical impacts of their adoption., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The influence of n-octylammonium iodide (OAI, passive layer) on the types of phases formed in a (MACl) 0.33 FA 0.99 MA 0.01 Pb(I 0.99 Br 0.01 ) 3 perovskite film was studied using X-ray diffraction. Using UV spectrophotometric techniques, it was determined how varied OAI additive layer ratios affected the linear and nonlinear optical characteristics of glass substrates/FTO/compact TiO 2 /mesoporous TiO 2 /(MACl) 0.33 FA 0.99 MA 0.01 Pb(I 0.99 Br 0.01 ) 3 films. All films' direct optical bandgap energies were determined to be 1.54 eV. The effects of OAI addition on the films' photoluminescence intensity and emitted colors were also investigated. For the fabricated perovskite solar cells (PSCs) without an OAI passivation layer, the corresponding power conversion efficiency (PCE), open-circuit voltage (V OC ), short-circuit current density (J SC ), and fill factor (FF) values were 18.8%, 1.02 V, 24.6 mAcm -2 , and 75%, respectively. When the concentration of OAI reached 2 mg, the maximum obtained values of PCE, V OC , J SC , and FF were 20.2%, 1.06 V, 24.2 mAcm -2 , and 79%, respectively. The decreased trap density and increased recombination resistance were responsible for the improvement in solar cell performance.

Drug-pepsin interaction possibly affects pepsin activity, leads to undesirable shift of its functionality, and likely induces adverse effects in the gastrointestinal tract. The present study aims at exploring the interaction of pepsin with the antiprotozoal/antibacterial drug secnidazole adopting a combination of experimental spectroscopy and computational techniques. For this purpose, different spectroscopic methods including fluorescence, synchronous fluorescence, UV-Visible absorption, and infrared spectroscopy were adopted and coordinated with in silico analysis via molecular docking. The employed synchronized approaches evidenced that; pepsin interacted with secnidazole via static mechanism at stomach pH inferring some consequent conformational changes in the structure of pepsin. Thermodynamic study of drug-pepsin interaction demonstrated that the interaction is spontaneous via van der Waals and hydrogen bonding interaction and the orientation of ligand within pepsin cavity was illustrated by molecular docking. The synchronous fluorescence study proved that tyrosine amino acid residues were involved in the interaction more than tryptophan amino acid residues. Eventually, the combined experimental and molecular docking approaches suggest that secnidazole interacts with pepsin and alter its structure, that finding correlates to gastrointestinal side effects related to secnidazole oral administration., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)