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Background: Pre-diabetes, characterized by elevated glycemic indices, poses a high risk of diabetes development, and is increasingly linked to non-specific low back pain. While mechanisms remain incompletely understood, metabolic, inflammatory, and neurological factors are implicated. Dietary interventions, including low-glycemic and anti-inflammatory diets, alongside weight management, may improve outcomes in this population. Objectives: In this non-randomized controlled trial, we aim to evaluate the influence of decreasing HbA1c levels on reducing chronic non-specific low back pain in pre-diabetic, non-obese individuals, as well as emphasizing the importance of such a study in supporting the literature. Methods: A non-randomized controlled single-blind clinical trial was conducted among 82 participants with chronic non-specific low back pain and pre-diabetes at an outpatient clinic in Baghdad from the 30th of January to the 22nd of September. The intervention methods aimed at reducing HbA1c levels to assess the reduction impact on alleviating chronic non-specific low back pain included dietary adjustments, sleep optimization, and correction of vitamins and minerals deficiencies. The follow-up process was conducted individually for each participant, with a monthly assessment over a period of six months. Results: At 12 weeks a significant decrease in chronic non-specific low back pain severity was observed in patients with lower HbA1C levels yielding a P -value of .021. Similarly, at 24 weeks there was a decline in the number of patients who reported chronic non-specific low back pain, and the association to lower HbA1C levels was significant with a p -value of .005. Conclusion: This study suggests the presence of a statistically significant association between reduction of HbA1C levels and ensuing improvement in chronic non-specific low back pain symptoms in non-obese prediabetic patients.

Objectives: Type 2 diabetes mellitus (T2DM) is a persistent metabolic illness causing elevated glucose levels due to insulin resistance. Social media has been found to positively impact diabetes management by boosting motivation, adherence, emotional support, and sharing evidence-based information, thereby enhancing patients’ glycemic control efforts and achieving HbA1c targets. Primarily to examine the influence of social media within a random sample Iraqi population of T2DM patients on the control of diabetes, as measured by HbA1c levels. Methods: A multicentric cross-sectional study involves patients diagnosed with T2DM recruited between December 30, 2019 and November 8, 2023. Patients diagnosed with T2DM, who visited the outpatient clinic at least twice during the study period, were included. The sample size comprised 2921 patients. Various social media platforms available including, Facebook, WhatsApp, Instagram, Telegram, X (formerly known as Twitter), and Viber, were reported. Results: The study involves 2921 participants with a mean age of 53.3 years, 56% of them successfully reached their HbA1c target within a mean of 18.17 months. A significant correlation was found between achieving the target and using social media ( P = .0001), with a shorter average duration among social media users compared to non-users. A family history of diabetes also significantly correlated with achieving the desired outcome, suggesting a probable positive correlation ( P = .019). Conclusion: The study reveals a significant association between social media usage and glycemic control, introducing the importance of technology-based interventions in enhancing diabetes self-management, highlighting the relationships between social media engagement and HbA1c target achievement.

The play Rosmersholm, one of the social plays aimed at the upper class of society, the clergy, simulates the Norwegian reality on a narrow level in conveying the situation surrounding Rosmersholm. The play begins with the loss of one of its pillars, which is the pastor's wife, Rosmer. The play consists of four chapters and is a social epic that conveys a state of salvation, socio-religious liberation and adherence resulting from family legacies that turn a person towards what he does not aspire to. This study aims to research the symbolism of the spiritual personality and its behaviours to present this type of class that remained closed for a long time and cannot be explored by the general public. It also provides an analytical study of free personalities, resulting in knowledge of the extent of the influence of religion and freedom on individuals. At that time, these two types of characters were considered incompatible and did not meet due to the nature of the religious symbol, closed in on itself, and its distance from religiosity and the church. Combining them together leads to one of the following results: - Aversion. - Convergence.

BackgroundOn April 15, 2023, the armed conflict between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) started in Khartoum state, Sudan. This conflict was complicated by the preexisting complicated epidemiological situation and fragile health system in Sudan. This study endeavors to illuminate the pivotal role essayed by the Sudan FETP (SFETP) in enhancing the nation’s public health response, particularly amidst the tumultuous backdrop of armed conflicts that have left their indelible mark on the region.MethodsEmploying a blend of quantitative and qualitative methodologies, we investigated the SFETP’s contributions to the public health response during the initial 4 months of the conflict (April–July 2023). Sixty-four SFETP residents and graduates were invited to participate, and data were gathered through semi-structured questionnaires.ResultsA total of 44 (69%) SFETP residents and graduates were included in this study. Out of 38 SFETPs present in the states, 32 have considerably contributed to the crisis response at state and locality levels. Three-quarters of them have played key leadership, planning, and management roles. In essence, 38% (n = 12) of them have contributed to public health surveillance, particularly in data management, reports, Early Warning Alert and Response System (EWAR) establishment, and epidemic investigation. SFETPs have made special contributions to crisis response at the community level. The involved SFETPs supported WASH interventions (n = 4), and almost one-third of them strengthened risk communication and community engagement (n = 9). Despite their physical presence at the subnational level, 27% of graduates were not deployed to the crisis emergency response. Notably, throughout this time, half of the total SFETPs were formally retained during this response.ConclusionThe study highlighted the importance of FETP engagement and support during public health crises. SFETP residents and graduates played diverse roles in the various levels of public health emergency response to the crisis. However. Strategies to improve the deployment and retention of FETP residents are necessary to ensure their availability during crises. Overall, FETP has proven to be an asset in public health crisis management in Sudan.

OBJECTIVE: To evaluate the role of serum sialic acid as a non-invasive biomarker of Leukoplakia and oral cancer. METHODOLOGY: This comparative cross-sectional study was conducted from December 2017 to November 2019 at the Institute of Biochemistry and Tertiary care hospital, Larkana. The 34 diagnosed cases of oral Leukoplakia and Erythroplakia were 20 to 72 years age. The controls with history of using tobacco, areca nut, alcohol, corticosteroid drugs and systemic diseases were excluded from this study. The dysplasia was graded istopathologically as mild, moderate and severe. The Blood samples were collected and centrifuged at 3000 rpm for 15 minutes; then, serum was separated and Sialic Acid was analyzed spectrophotometrically. Finally, Statistical analysis was done by SPSS version 20 and results were expressed with mean and standard deviation. RESULTS: Out of 34 cases and controls15 (44.1%) were male, and 19(55.9%) were female. Their ages were from 20 to 72 years, and the mean age was 47.47±17.97. The typical sites of lesion were buccal mucosa 35.3%, tongue 26.5%, right cheek 14.70%, left cheek 8.8%, Juxta mandibular area 8.8% and lip 2.9%, respectively. Clinically Oral Leukoplakia was 58.8% and Erythroplakia 29.4%. The Sialic Acid levels were 78.7±16.6 mg/dl in Leukoplakia, 105.4±22mg/dl in Erythroplakia and was 60.2±4 mg/dl in controls. The serum sialic acid levels were increased in case group as compared to control group in both genders, with significant p-value 0.001. CONCLUSION: The Sialic Acid levels were significantly increased in cases of Oral Leukoplakia and Erythroplakia as compared to healthy controls.

BackgroundMalaria and dengue are common mosquito-borne diseases around the world that cause high mortality and morbidity. The number of cases of both diseases is currently rising in Sudan and is associated with climate and environmental changes. Limited information is available on malaria and dengue co-infections and the severity of the two diseases among febrile patients in eastern Sudan. Thus, this study aimed to estimate the prevalence of malaria and dengue co-infections among febrile patients in Kassala, eastern Sudan.Methodology/principal findingsA cross-sectional hospital-based study was conducted among febrile patients from September to December 2019. A total of 395 patients were enrolled after consenting to participate in the study. Demographic and clinical data were collected by structured questionnaires. Blood samples were provided to diagnose malaria infections using microscopy and polymerase chain reaction (PCR) and for serology diagnosis of dengue using enzyme-linked immune sorbent assay (ELISA) IgM. Multiple logistic regression analysis was used to assess the association between demographic information, clinical symptoms and malaria and dengue co-infections. Out of 395 febrile patients examined 158 (40%) were malaria positive and 67 (17%) were dengue positive. The prevalence of malaria and dengue co-infections was 6.6% (26/395). Results of multiple logistic regression indicated that elder patients (41-60 years) had less rate of co-infections (OR = 0.3, 95% CI 0.11 to 0.81, p-value = 0.018), while patients of co-infections were eight times more likely to have fatigue, and two times more likely to suffer from joint and muscle pain and this difference was statistically significant with (OR = 8.3, 95% CI: 1.89 to 37.22, p-value = 0.005) and (OR = 2.4, 95% CI 1.10 to 5.39, p-value = 0.027), respectively.Conclusions/significanceThis study confirmed the existence of malaria and dengue co-infections among febrile patients in Kassala, eastern Sudan for the first time. The severity of clinical symptoms of patients with malaria and dengue co-infections was observed, and the co-infections were found prevalent among young people.

Key Clinical Message We report a case of febrile illness that was presented with mild symptoms. However, laboratory investigation confirmed a malaria and Rift Valley fever co‐infection. Healthcare providers in settings endemic with several infectious diseases should seek rolling out possibilities of other infections prior to starting treatment for achieving effective case management with less resources and better safety of patients. Abstract Here we report a case of febrile illness that confirmed to be a co‐infection of malaria and Rift Valley fever. The patient was initially diagnosed with malaria and started on treatment immediately. However, due to the lack of response to the treatment further laboratory investigations were pursued.

This article describes a power plant that is versatile regarding its modeling and associated with a Multiple Objectives Particle Swarm optimization in order to determine the optimal size of each component of the power plant. The simulation is appropriate for a variety of power sources, storage devices and loads. The method is utilized on a Wind Turbine/ Photovoltaic Device/ Battery System setup located in Tilos, Greece. The optimization is intended to reduce the expense of the system and the energy derived from alternative sources that are not renewable. The results produce a Pareto front that represents the expense of the equipment and the degree of autonomy of the micro-grid. The most effective solution to a specific expense associated with energy importation is demonstrated as an example.

Background: Cervical cancer is considered the third leading cause of death among women worldwide, and human papillomavirus was identified as a major causative agent for developing cervical cancer. Objectives: This study aimed to assess the knowledge and attitudes towards cervical cancer prevention among women in Khartoum state, Sudan. Design: A community-based cross-sectional study implemented in Khartoum state, Sudan, from 1 August 2020 to 1 September 2020. Methods: We conducted a descriptive cross-sectional community-based study using an electronic questionnaire for data collection. Descriptive statistics, frequency, mean, and percentage were computed. Results: The study included 716 female participants with a mean age of 27.6 + 8.7 years. 580 (81.0%) and 229 (32.0%) had heard about cervical cancer and Pap test, respectively. cervical cancer was assumed related to alcohol consumption 109 (15.2%), giving birth to many children 51 (7.1%), ageing 118 (16.5%), and having many sexual partners 335 (46.8%). In addition, 300 (41.9%) attributed cervical cancer to having human papillomavirus infection, 256 (35.6%) to the prolonged use of contraceptives, and 162 (22.6%) to smoking. Knowledge about the best time to be vaccinated against human papillomavirus, 110 (15.4%) stated it is better after marriage. Regression models to predict the effectors on participants’ knowledge and attitudes showed a low standard deviation of the estimates with higher values of the adjusted R 2 [R: 0.041, 0.017, and 0.006; std: 1.527, 0.417, and 0.426]. This indicates the combined influence of occupation, educational level, family income, and marital status on the participant’s knowledge and attitude levels. Conclusion: This study revealed that the participant’s knowledge and attitudes levels are mainly driven by their occupation, educational level, family income, and marital status altogether. This underscores the need for a countrywide community engagement campaign through health education and raising awareness sessions, and massive social media to sensitize the community and healthcare providers about the risk of cervical cancer and the available prevention and control measures.

Background: The complement system is made up of an abundance of unique plasma proteins that play an important role in innate immunity and inflammation, aiding in the fight against pathogenic microbes and viral diseases. The purpose of this study was to evaluate the serum complement C4 concentration in COVID-19 patients in Khartoum and compare them to healthy controls. Methods: A total of 100 samples were collected, 50 samples from COVID-19 patients who presented as cases and 50 samples from people who were evidently healthy. Overall, 33 (66%) the patient populations in the case group were not in the hospital’s intensive care unit (ICU), compared to 17 (34%) who were. The concentrations of C4 in each serum sample were calculated in milligrams per deciliter. SPSS version (20) was used to analyze the data. Results: The means level of complement C4 (mg/dL) were 37.44±18.618, 23.90±10.229 in the case group and in the control group, respectively. There was a statistically significant difference in complement C4 level between case and control (p-values ≤0.01). In addition, the mean complement C4 level in the ICU and non-ICU case groups was 25.00±17.85 and 43.85±15.712 mg/dL, respectively. There was a statistically significant variance in complement C4 level between ICU and non-ICU (p-values ≤0.01). Furthermore, the cases were divided into four age groups: 20-40, 40-60, 60-80, and over 80 years old. The one-way ANOVA test showed no statistically significant differences between age categories in complement C4 level (P = 0.735) Conclusions: The case group had a higher mean level of complement C4 than the control group, which could be understood by the stimulation of the complement cascade during the COVID-19 illness. Furthermore, the complement C4 level in severe COVID-19 patients was lower than in non-severe COVID-19.

Abstract In this communication, we reported a series of six patients presented with Guillain‐Barré syndrome that associated with COVID‐19 infection, which was confirmed with RT‐PCR. Here we discuss the laboratory investigation and case management, as well as clinical presentation and outcome of each case. The current report demonstrated the first case series of COVID‐19‐associated GBS‐cases in Sudan.

We report hepatitis E virus (HEV) outbreaks among refugees from Ethiopia in Sudan during June 2021–February 2022. We identified 1,589 cases of acute jaundice syndrome and used PCR to confirm HEV infection in 64% of cases. Implementing vaccination, water, sanitation, and hygiene programs might reduce HEV outbreak risk.

Abstract Background The currently used malaria vaccine, RTS,S, is designed based on the Plasmodium falciparum circumsporozoite protein (PfCSP). The pfcsp gene, besides having different polymorphic patterns, can vary between P. falciparum isolates due to geographical origin and host immune response. Such aspects are essential when considering the deployment of the RTS,S vaccine in a certain region. Therefore, this study assessed the genetic diversity of P. falciparum in Sudan based on the pfcsp gene by investigating the diversity at the N-terminal, central repeat, and the C-terminal regions. Methods A cross-sectional molecular study was conducted; P. falciparum isolates were collected from different health centres in Khartoum State between January and December 2019. During the study period, a total of 261 febrile patients were recruited. Malaria diagnosis was made by expert microscopists using Giemsa-stained thick and thin blood films. DNA samples were examined by the semi-nested polymerase chain reaction (PCR). Single clonal infection of the confirmed P. falciparum cases, were used to amplify the pfcsp gene. The amplified amplicons of pfcsp have been sequenced using the Sanger dideoxy method. The obtained sequences of pfcsp nucleotide diversity parameters including the numbers of haplotypes (Hap), haplotypes diversity (Hapd), the average number of nucleotide differences between two sequences (p), and the numbers of segregating sites (S) were obtained. The haplotype networks were constructed using the online tcsBU software. Natural selection theory was also tested on pfcsp using Fuand Li’s D, Fuand Li’s F statistics, and Tajima’s D test using DnaSP. Results In comparison with the different pfcsp reference strains, the Sudanese isolates showed high similarity with other African isolates. The results of the N-terminal region showed the presence of 2 different haplotypes with a Hapd of 0.425 ± 0.00727. The presence of the unique insertion of NNNGDNGREGKDEDKRDGNN was reported. The KLKQP motif was conserved in all the studied isolates. At the central repeat region, 11 haplotypes were seen with a Hapd of 0.779 ± 0.00097. The analysis of the genetic diversity in the C-terminal region showed the presence of 10 haplotypes with a Hapd of 0.457 ± 0.073. Several non-synonymous amino acids changes were also seen at the Th2R and the Th3R T-cell epitope regions including T317K, E317K, Q318E, K321N, I322K, T322K, R322K, K324Q, I327L, G352N, S354P, R355K, N356D, Q357E, and E361A. Conclusions In this study, the results indicated a high conservation at the pfcsp gene. This may further contribute in understanding the genetic polymorphisms of P. falciparum prior to the deployment of the RTS,S vaccine in Sudan.

Mycetoma is a neglected tropical disease that is associated with poor communities and socioeconomically impaired individuals in the tropical and sub-tropical areas. Interestingly, the disease is caused by either bacteria (actinomycetoma) or fungus (eumycetoma). The latter form of the disease, eumycetoma, is the most common type in Africa. Eumycetoma is characterized by a prolonged disease duration and low cure rate. The effective case management of eumycetoma largely depends on the accurate diagnosis and identification of the causative agent to the species level and evaluating its susceptibility to the available drugs. This review summarizes the currently available and used antifungal agents for the treatment of eumycetoma and discusses optimizing the newly developed antifungals as a potential second line for eumycetoma treatment.

Objectives: This study aimed to investigate an outbreak of a non-malaria, undifferentiated febrile illness, among internally displaced persons (IDPs) living in humanitarian camps in North Darfur, Sudan, in 2019. Methods: An investigation team was deployed to North Darfur to identify suspected cases and collect blood samples, and clinical and demographical data. Blood samples were examined microscopically for Plasmodium spp and tested for dengue (DENV) and yellow fever viruses by reverse transcriptase-quantitative polymerase chain reaction. Results: Between September 7 and December 18, 2019, we clinically identified 18 (24%), 41 (54%), and 17 (22%) cases of dengue fever, dengue with warning signs, and severe dengue, respectively. Blood samples were collected from 22% of patients, and 47% of these tested positive for DENV-1 RNA. We confirmed 32 malaria cases with 5 co-infections with DENV. This outbreak of dengue was the first among IDPs in the humanitarian camps. Conclusions: Our findings indicate that dengue has become endemic or that there has been a new introduction. Further epidemiological, entomological, and phylogenetic studies are needed to understand disease transmission in the area. An early warning and response system and an effective health policy are crucial for preventing and controlling arboviruses in Sudan.

We report a unique outbreak of Rift Valley fever in the Eldamar area, Sudan, May–July 2019, that resulted in 1,129 case-patients and 19 (1.7%) deaths. Patients exhibited clinical signs including fever (100%), headache (79%), and bleeding (4%). Most (98%) patients also reported death and abortions among their livestock.

Abstract Objectives Malaria infection is still known to be a worldwide public health problem, especially in tropical and sub-tropical African countries like Sudan. A pilot study conducted to describe the trend of P. falciparum drug resistance markers in 2017–2018 in comparison to CQ and AS/SP eras in Sudan. The Pfcrt, Pfmdr-1, Pfdhfr, and Pfdhps genes were investigated. Data deposited by the worldwide antimalarial resistance network was consulted, and the molecular markers previously reported from Sudan were analyzed. Results Drug molecular markers analysis was successfully done on 20 P. falciparum isolates. The Pfcrt K76 showed high frequency; 16 (80%). For the Pfmdr-1, 9 (45%) isolates were carrying the N86 allele, and 11 (55%) were 86Y allele. While the Y184F of the Pfmdr-1 showed a higher frequency of 184F compared to Y184; 16 (80%) and 4 (20%), respectively. In the Pfdhfr, 51I allele showed higher frequency compared to N51; 18 (90%) and 2 (10%), respectively. For S108N, 18 (90%) were 108 N and 2 (10%) were S108. In the Pfdhps, all isolates were carrying the mutant alleles; 437G and 540E. The frequency distribution of the Pfcrt, Pfmdr-1, Pfdhfr, Pfdhps was significantly different across the whole years in Sudan.

Introduction: Climate change is impacting the life, health, and security of people worldwide with poor communities and displaced populations at particular risk due to lack of awareness and mitigation plans. The Tigray war in Ethiopia has forced thousands of refugees to flee and seek safety and shelter in Sudan. Methods: We investigated the impacts of climate change on this displaced population with a focus on the conditions experienced by Ethiopian humanitarian refugees who fled from the Tigray war in Ethiopia and settled in the Gedaref state, East Sudan. We analyzed data regarding the displaced population and climate-related weather effects in Sudan. Results: Sudan is currently hosting over 63 thousand Ethiopian refugees who arrived between November 2020 and April 2021. These refugees were exposed to severe weather conditions including heavy rains, strong storms, severe floods, and heat waves which resulted in over 50% loss of their shelters and belongings, and around two thousand latrines were destroyed. Furthermore, an outbreak of Hepatitis E virus is ongoing among refugees with nearly one thousand cases reported. Massive and routine vaccination campaigns were launched to avoid the spread of locally transmitted diseases among the refugees including COVID-19, polio, cholera, and measles. Conclusion: The living conditions and lack of reliability of essential services among the displaced populations are increasing their vulnerability to the negative impacts of climate change on their life, health, and security. We recommend incorporating a mitigation and adaptation plan to climate change into humanitarian response plan and strategies, including raising awareness and training, in order to prepare a well-developed contingency plan that takes these factors into account.

Accurate estimation of forest aboveground biomass (AGB) using remote sensing is a requisite for monitoring, reporting and verification (MRV) system of the United Nations Programme on Reducing Emissions from Deforestation and Forest Degradation. However, attaining high accuracy remains a great challenge in the diverse tropical forests. Among available technologies, l-band Synthetic Aperture Radar (SAR) estimates AGB with reasonably high accuracy in the terrestrial tropical forests. Nevertheless, the accuracy is relatively low in the mangrove forests. In this context, the study was carried out to model and map AGB using backscatter coefficients of Advanced Land Observing Satellite-2 (ALOS-2) Phased Array l-band SAR-2 (PALSAR-2) in part of the restored mangrove forest at Mahakam Delta, Indonesia. PALSAR-2 data was acquired with image scene observation during the peak low tide on 30 July 2018 from Japan Aerospace Exploration Agency. The forest parameters namely tree height and diameter at breast height were measured from 71 field plots in September-October 2018. The parameters were used in mangrove allometry to calculate the field AGB. Finally, HV polarized backscatter coefficients of PALSAR-2 were used to model AGB using linear regression. The model demonstrated a comparatively high performance using three distinct methods viz. independent validation (R2 of 0.89 and RMSE of 23.16 tons ha−1), random k-fold cross validation (R2 of 0.89 and RMSE of 24.59 tons ha−1) and leave location out cross validation (LLO CV) (R2 of 0.88 and RMSE of 24.05 tons ha−1). The high accuracy of the LLO CV indicates no spatial overfitting in the model. Thus, the model based on LLO CV was used to map AGB in the study area. This is the first study that successfully obtains high accuracy in modeling AGB in the mangrove forest. Therefore, it offers a significant contribution to the MRV mechanism for monitoring mangrove forests in the tropics and sub-tropics.

Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic arboviral disease that poses a great threat to global health in the Old World, and it is endemic in Europe, Asia, and Africa, including Sudan. In this retrospective study, we reviewed previous epidemiological reports about the major epidemics of CCHF throughout Sudan between 2010 and 2020. During these epidemics, the infection of humans with Crimean-Congo hemorrhagic fever virus (CCHFV), the causative agent of CCHF, was diagnosed using qRT-PCR. We have identified 88 cases of CCHF, including 13 fatalities reported during five epidemics that occurred in 2010, 2011, 2015, 2019, and 2020. The two epidemics in 2010 and 2011 were by far the largest, with 51 and 27 cases reported, respectively. The majority of cases (78%) were reported in the endemic region of Kordofan. Here, we document that the first emergence of CCHFV in the Darfur region, West Sudan, occurred in 2010. We were not able to investigate outbreak dynamics through phylogenetic analysis due to the limited diagnostic capacity and the lack of sequencing services in the country. These findings call for establishing a genomic-based integrated One Health surveillance and response system for the early preparedness, prevention, and control of CCHF in the country.

Background and Objective: Posttraumatic stress disorder is a psychiatric disorder that occurs in people who have experienced or witnessed a life threatening event. This study aimed to assess the prevalence and risk factors of posttraumatic stress disorder among Syrian refugees in Domiz Camp in Duhok City. Methods: Through a cross-sectional study, 500 Syrian refugees were interviewed using the Posttraumatic Stress Disorder Checklist Civilian version (PCL-C) which was translated into the Arabic language. The sample was selected randomly. Refugees who were 20 years old and older and from both sexes were included, and those with severe medical diseases and serious psychiatric diseases (psychotic conditions and mentally retarded) were excluded. Data analysis had been done using the statistical package for the social sciences. Results: The prevalence of posttraumatic stress disorder was 25.2% (126 cases). There was statistically significant association between the occurrence of PTSD and some variables such as female (28.7%; P = 0.003), housewife (28.5%; P = 0 .012) and nearly significant association with the positive family psychiatric history (42.9%; P = 0.057). The results showed no statistically significant association between the occurrence of posttraumatic stress disorder and other variables such as age (P = 0.106), educational level (P = 0.148), marital status (P = 0.210) and patient past psychiatric history (P = 0.164). Conclusions: The high prevalence of posttraumatic stress disorder among the Syrian refugees (25.2%) makes it one of the most important mental health issues that should be taken into consideration. The females, housewives and those with a positive family psychiatric history are regarded among high risk groups. Early detection and better management of those groups may be of high priority.

We report an outbreak of dengue in Darfur, western Sudan, during September 2014–April 2015. Dengue virus–specific PCR testing of 50 samples from nonmalaria febrile illness case-patients confirmed 35 dengue cases. We detected 7 cases of dengue shock syndrome and 24 cases of dengue hemorrhagic fever.

Dengue virus (DENV) is an arthropod-borne virus (arbovirus) transmitted by the Aedes mosquitoes, mainly Aedes aegypti. Dengue fever is a rapidly growing disease with expanding geographical distribution worldwide. We investigated a high number of non-malaria febrile cases reported to health clinics in refugee camps in the five states of Darfur between August 2015 and March 2016. The clinical presentation of cases and case definition criteria suggested involvement of one or more arboviral hemorrhagic fevers. Out of 560 suspected cases, we collected and analyzed 204 blood samples and serologically positive samples were confirmed by PCR. We identified 32 (15.7%) dengue viral infections, six West Nile virus infections, and three Crimean–Congo viral infections. Dengue infections were found in four out of the five Darfur states. We reported the first dengue fever outbreak in the Darfur region. Our results highlight the need for public health education and further molecular, phylogenetic, and entomological investigations for a better understanding of the disease transmission and the associated risk factors in the region.

ABSTRACT:This work includes synthesis of new esters compounds for - D - glucitol on the primary hydroxyl group ( C1 , C6 ) in the glucitol molecule by the reaction of glucitol with pure fatty acid esters as ( Methyl butyrate , Methyl hexanoate , Methyl octanoate , Methyl laurate , Ethyl palmitate , Methyl stearate ) to obtain 1 , 6 – di – O – ester – D – glucitol ( A-F ) or with crude Oil ( tri glyceride ) as ( Palm oil, Olive oil , corn oil , Sun flower oil,Cotton oil ) to obtain mixture esters compounds 1 , 6 – di – O – ester – D – glucitol ( G - K ) These compounds prepared by Transesterification method also detected the reaction flow of ( T.L.C ) technique . These compounds characterized spectrometric by ( I . R ) , ( 1H – NMR ) , ( 13C – NMR ) and elemental analysis ( C.H.N.S ) .Also this work includes studying some physical properties for preparing ester compounds as foam test , surface tension to know that is used capability as Detergents and Emulsions . This studying shows that the prepared compounds are having good detergent and emulsion properties and on the other field the studying biological activity for prepared compound this test proved been posess some compound biological activity and can be utilized as antibacterial

Background: The complement system is made up of an abundance of unique plasma proteins that play an important role in innate immunity and inflammation, aiding in the fight against pathogenic microbes and viral diseases. The purpose of this study was to evaluate the serum complement C4 concentration in COVID-19 patients in Khartoum and compare them to healthy controls. Methods: A total of 100 samples were collected, 50 samples from COVID-19 patients who presented as cases and 50 samples from people who were evidently healthy. Overall, 33 (66%) the patient populations in the case group were not in the hospital’s intensive care unit (ICU), compared to 17 (34%) who were. The concentrations of C4 in each serum sample were calculated in milligrams per deciliter. SPSS version (20) was used to analyze the data. Results: The means level of complement C4 (mg/dL) were 37.44±18.618, 23.90±10.229 in the case group and in the control group, respectively. There was a statistically significant difference in complement C4 level between case and control (p-values ≤0.01). In addition, the mean complement C4 level in the ICU and non-ICU case groups was 25.00±17.85 and 43.85±15.712 mg/dL, respectively. There was a statistically significant variance in complement C4 level between ICU and non-ICU (p-values ≤0.01). Furthermore, the cases were divided into four age groups: 20-40, 40-60, 60-80, and over 80 years old. The one-way ANOVA test showed no statistically significant differences between age categories in complement C4 level (P = 0.735) Conclusions: The case group had a higher mean level of complement C4 than the control group, which could be understood by the stimulation of the complement cascade during the COVID-19 illness. Furthermore, the complement C4 level in severe COVID-19 patients was lower than in non-severe COVID-19.

Tapered beams are characterized by varying moments of inertia along their span, commonly the pier cap configuration used in bridge construction. This study presents the shear behavior of tapered beams reinforced with basalt fiber–reinforced polymer (BFRP) bars through experiments and analyses. Eight BFRP beams were tested to explore the influence of changing inclination angles and the presence of BFRP stirrups. These beams were divided into two groups, each consisting of four beams: one control straight beam and three tapered beams with different tapered angles. The first group was without shear reinforcement, while the second group was reinforced with BFRP stirrups. Results revealed that increasing tapered angles decreased the shear strength of BFRP tapered beams without stirrups but increased it in beams with BFRP stirrups. The analytical part proposed equations to estimate the shear strength of BFRP tapered beams, with findings indicating conservative estimations consistent with experimental data trends. [ABSTRACT FROM AUTHOR]