Pathological response for neoadjuvant chemotherapy in locally advanced breast cancer at NCI, Sudan: 6 years’ experience

Background: Breast cancer is the leading cancer in Sudanese females.Objectives: This study was done to evaluate the clinical response to neoadjuvant chemotherapy for patients treated at National Cancer Institute (NCI) and to compare it with the published literature.Methods: This is a retrospective study conducted in National Cancer Institute (NCI), Gezira State, Sudan during the period from April 2005 to August 2011. We studied the data for all patients who have locally  advanced breast cancer and treated at NCI during study period. Patients who remained inoperable after treatment were considered as having no response to therapy. Data were introduced and analyzed using SPSS software. Data evaluated includes Patient age, disease stage,  chemotherapy regimens, and number of cycles, tumor histology, grade and histopathology after chemotherapy.Results: A total of 110 patients who received neoadjuvant chemotherapy and fulfilled criteria for inclusion during the period 2005 to 2011 were evaluated. Majority of patients were between 30-50 years of age (63%). Patients who achieved response and had surgery were 65%. Among those who underwent surgery 22% have complete pathological response. Most of patients who achieved complete histopathological response had six cycles of chemotherapy.Conclusion: this study demonstrated that neoadjuvant systemic therapy is an accepted approach for women with locally advanced breast cancer for whom immediate surgery is inappropriate, and we achieved results similar to the international literature.Key words: breast cancer, neoadjuvant, chemotherapy, response, NCI, Sudan

Metabolic Syndrome among Undergraduate Students Attending Medical Clinics for Obligatory Medical Screening

Purpose: To determine the prevalence and risk factors for metabolic syndrome (MS) among first-year undergraduate students in three Sudanese universities.Methods: A total of 384 first-year students attending university medical clinics for obligatory medical checkup in Khartoum, Sudan participated in this cross-sectional study. Anthropometric parameters, including weight, height, body mass index (BMI) and waist circumference (WC) were measured with reference to National Cholesterol Education Program’s Adult Treatment Panel III (NCEP/ATP III) guidelines. Fasting blood samples were collected from all participants and assayed for fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), and low density lipoprotein (LDL).Results: The overall prevalence of MS in the test group was 7.8 %. The prevalence of MS, though higher in females, was statistically not significant (p = 0.32). According to residential area (rural – urban), the prevalence was higher in urban than rural, 10.4 and 4.4 %, respectively (p = 0.25 and p = 0.25, respectively). In addition, frequency of MS was directly proportional to age. The weight of patients with MS was significantly different from that of non-MS subjects (p ˂ 0.001). Same was also observed when obese patients were compared with non-MS subjects. (p ˂ 0.001).Conclusion: The prevalence of MS among Sudanese first-year university students in Khartoum is moderately high. Incidence of MS among the students is directly proportional to BMI.Keywords: Metabolic syndrome, Obesity, Hypertension, Diabetes, Dyslipidemia, Anthropometri

Concomitant malaria among visceral leishmaniasis in-patients from Gedarif and Sennar States, Sudan: a retrospective case-control study

In areas where visceral leishmaniasis (VL) and malaria are co-endemic, co-infections are common. Clinical implications range from potential diagnostic delay to increased disease-related morbidity, as compared to VL patients. Nevertheless, public awareness of the disease remains limited. In VL-endemic areas with unstable and seasonal malaria, vulnerability to the disease persists through all age-groups, suggesting that in these populations, malaria may easily co-occur with VL, with potentially severe clinical effects

Safety and immunogenicity of an autoclaved Leishmania major vaccine

Objective: To test the safety and immunogenicity of two doses of autoclaved L.major (ALM) vaccine mixed with BCG.Setting: Kala-azar endemic area of eastern Sudan.Design: This was a randomised, double blind and BCG controlled phase I/II study.Subjects: Eighty healthy volunteers (forty children and forty adults) with no past history of kala-azar, no reactivity to leishmanin antigen and with a reciprocal direct agglutination test (DAT) titre o

Prospective Applications of Artificial Intelligence In Fetal Medicine: A Scoping Review of Recent Updates

Elhadi Miskeen,1 Jaber Alfaifi,2 Dalal Mohammed Alhuian,3 Mushabab Alghamdi,4 Muffarah Hamid Alharthi,5 Nourah Abdullah Alshahrani,3 Ghala Alosaimi,6 Raydaa Abdullah Alshomrani,3 Abdullah Mohammed Hajlaa,3 Nadir Mohammed Khair,7 Abdullah Mohammed Almuawi,3 Khalifa Haytham Al-Jaber,8 Fath Elrahman Elrasheed,9 Kamal Elhassan,5 Mohammed Abbas10 1Department of Obstetrics and Gynecology, College of Medicine, University of Bisha, Bisha, Saudi Arabia; 2Department of Child Health, College of Medicine University of Bisha, Bisha, Saudi Arabia; 3Medical Student, College of Medicine University of Bisha, Bisha, Saudi Arabia; 4Department of Internal Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia; 5Department of Family and Community Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia; 6Medical student, College of Medicine, Taif University, Taif, Saudi Arabia; 7Department of Child Health, Mother and Children Hospital, Bisha, Saudi Arabia; 8Medical student, Royal College of Surgeons, Dublin, Ireland; 9Department of Obstetrics and Gynecology, Faculty of Medicine Najran University, Najran, Saudi Arabia; 10Department of Pediatrics, College of Medicine, Arab Gulf University, Al Manama, BahrainCorrespondence: Elhadi Miskeen, Head Department of Obstetrics and Gynecology, College of Medicine, University of Bisha, P. O. Box 731, Bisha, 61922, Saudi Arabia, Email [email protected]: With the incorporation of artificial intelligence (AI), significant advancements have occurred in the field of fetal medicine, holding the potential to transform prenatal care and diagnostics, promising to revolutionize prenatal care and diagnostics. This scoping review aims to explore the recent updates in the prospective application of AI in fetal medicine, evaluating its current uses, potential benefits, and limitations.Methods: Compiling literature concerning the utilization of AI in fetal medicine does not appear to modify the subject or provide an exhaustive exploration of electronic databases. Relevant studies, reviews, and articles published in recent years were incorporated to ensure up-to-date data. The selected works were analyzed for common themes, AI methodologies applied, and the scope of AI’s integration into fetal medicine practice.Results: The review identified several key areas where AI applications are making strides in fetal medicine, including prenatal screening, diagnosis of congenital anomalies, and predicting pregnancy complications. AI-driven algorithms have been developed to analyze complex fetal ultrasound data, enhancing image quality and interpretative accuracy. The integration of AI in fetal monitoring has also been explored, with systems designed to identify patterns indicative of fetal distress. Despite these advancements, challenges related to the ethical use of AI, data privacy, and the need for extensive validation of AI tools in diverse populations were noted.Conclusion: The potential benefits of AI in fetal medicine are immense, offering a brighter future for our field. AI equips us with tools for enhanced diagnosis, monitoring, and prognostic capabilities, promising to revolutionize the way we approach prenatal care and diagnostics. This optimistic outlook underscores the need for further research and interdisciplinary partnerships to fully leverage AI’s potential in driving forward the practice of fetal medicine.Keywords: artificial intelligence, fetal medicine, prenatal care, machine learning, fetal monitoring, Bisha, Saudi Arabi

Capitate and hamate fracture in a child: the value of MRI imaging

Carpal bone fractures in children are rare, and little is known about the appropriate tools to diagnose them, particularly in toddlers. We present a 2-year-old child with a capitate and hamate fracture. Based on our experiences with this case and on a review of the literature, we discuss the value of magnetic resonance imaging in carpal trauma in children

Rare disease gene association discovery in the 100,000 Genomes Project

\ua9 The Author(s) 2025. Up to 80% of rare disease patients remain undiagnosed after genomic sequencing1, with many probably involving pathogenic variants in yet to be discovered disease–gene associations. To search for such associations, we developed a rare variant gene burden analytical framework for Mendelian diseases, and applied it to protein-coding variants from whole-genome sequencing of 34,851 cases and their family members recruited to the 100,000 Genomes Project2. A total of 141 new associations were identified, including five for which independent disease–gene evidence was recently published. Following in silico triaging and clinical expert review, 69 associations were prioritized, of which 30 could be linked to existing experimental evidence. The five associations with strongest overall genetic and experimental evidence were monogenic diabetes with the known β cell regulator3,4UNC13A, schizophrenia with GPR17, epilepsy with RBFOX3, Charcot–Marie–Tooth disease with ARPC3 and anterior segment ocular abnormalities with POMK. Further confirmation of these and other associations could lead to numerous diagnoses, highlighting the clinical impact of large-scale statistical approaches to rare disease–gene association discovery

Rare disease gene association discovery in the 100,000 Genomes Project

Up to 80% of rare disease patients remain undiagnosed after genomic sequencing1, with many probably involving pathogenic variants in yet to be discovered disease–gene associations. To search for such associations, we developed a rare variant gene burden analytical framework for Mendelian diseases, and applied it to protein-coding variants from whole-genome sequencing of 34,851 cases and their family members recruited to the 100,000 Genomes Project2. A total of 141 new associations were identified, including five for which independent disease–gene evidence was recently published. Following in silico triaging and clinical expert review, 69 associations were prioritized, of which 30 could be linked to existing experimental evidence. The five associations with strongest overall genetic and experimental evidence were monogenic diabetes with the known β cell regulator3,4 UNC13A, schizophrenia with GPR17, epilepsy with RBFOX3, Charcot–Marie–Tooth disease with ARPC3 and anterior segment ocular abnormalities with POMK. Further confirmation of these and other associations could lead to numerous diagnoses, highlighting the clinical impact of large-scale statistical approaches to rare disease–gene association discovery

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral