Pink1 type of Early Onset Parkinson’s disease(EOPD)in Sudanese patients, 2018

Background: Parkinson’sDisease (PD) is a neurodegenerative disorder affecting the motor system. It is a chronic progressive disorder which leads to long standing disability. Objective: To study the Presentations and pink1 gene in young Sudanese patients with Parkinson’s disease . Material and Methods: A prospective study was conducted among 31 PD patients at the National center for Neurological Science (NCNS) at Khartoum state. A structured questionnaire was used for data collection. Consisted of personal data, clinical presentations and investigations. RT-PCR technique using G-spin™ kit.  PINK1 gene was detected in most of the samples it was strongly positive. The data was analyzed using SPSS version 21. Results:. The majority of them 19 (61%) were located in age group 41 – 50 years; the mean age of onset was 33.4+_12 yrs.  19 (61%) of the subjects were males and 12 (39%) were female with ratio 1.6:1 (M: F),  20 (64.5%) were married. , 8 (40%) were endogamous married.  5 (62.5%) were second degree and 3 (37.5%) were third degree.  17 (85%) had children, 2 (10%) of the patient had children with Parkinson’s disease. 22 (71%) had duration more than 12 months, 12 (39%) age more than 40 years.  29 (93.5%) had tremor, 27 (87.1%) had rigidity and 23 (74.2%) had bradykinesia. 14 (45%) had positive family history of Parkinson’s disease. PINK1 gene expression was detected in 28 (90.3%) of the patients. no significant associations were found between PINK1 expression with age, gender, age at onset and family history (P> 0.05). Conclusion: This study concludes that early onset PD was common among male than female. The most affected age group was found to be 41 – 50 years and the mean age of onset 33.4yrs. Also, the patterns of the clinical features were generally similar to literature. PINK1 expression was predominant with no significant associations were found between PINK1 expression with age, gender, age at onset and family history.   Key words: , Early onset,, Parkinson’s disease, Pink1 gene, Sudan

The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis

Background A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done. Methods In this systematic review and meta-analysis, we searched five electronic databases for cross-sectional, case-control, or cohort studies published up to May 6, 2016, reporting risks of health outcomes, consisting of substance use, sexual health, mental health, weight and physical exercise, violence, and physical health status and conditions, associated with multiple ACEs. We selected articles that presented risk estimates for individuals with at least four ACEs compared with those with none for outcomes with sufficient data for meta-analysis (at least four populations). Included studies also focused on adults aged at least 18 years with a sample size of at least 100. We excluded studies based on high-risk or clinical populations. We extracted data from published reports. We calculated pooled odds ratios (ORs) using a random-effects model. Findings Of 11 621 references identified by the search, 37 included studies provided risk estimates for 23 outcomes, with a total of 253 719 participants. Individuals with at least four ACEs were at increased risk of all health outcomes compared with individuals with no ACEs. Associations were weak or modest for physical inactivity, overweight or obesity, and diabetes (ORs of less than two); moderate for smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three), strong for sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six), and strongest for problematic drug use and interpersonal and self-directed violence (ORs of more than seven). We identified considerable heterogeneity (I 2 of > 75%) between estimates for almost half of the outcomes. Interpretation To have multiple ACEs is a major risk factor for many health conditions. The outcomes most strongly associated with multiple ACEs represent ACE risks for the next generation (eg, violence, mental illness, and substance use). To sustain improvements in public health requires a shift in focus to include prevention of ACEs, resilience building, and ACE-informed service provision. The Sustainable Development Goals provide a global platform to reduce ACEs and their life-course effect on health. Funding Public Health Wales. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licens

Pink1 Type of Early Onset Parkinson's Disease(EOPD)in Sudanese Patients, 2018

Background: Parkinson'sDisease (PD) is a neurodegenerative disorder affecting the motor system. It is a chronic progressive disorder which leads to long standing disability. Objective: To study the Presentations and pink1 gene in young Sudanese patients with Parkinson's disease . Material and Methods: A prospective study was conducted among 31 PD patients at the National center for Neurological Science (NCNS) at Khartoum state. A structured questionnaire was used for data collection. Consisted of personal data, clinical presentations and investigations. RT-PCR technique using G-spin™ kit.  PINK1 gene was detected in most of the samples it was strongly positive. The data was analyzed using SPSS version 21. Results:. The majority of them 19 (61%) were located in age group 41 – 50 years; the mean age of onset was 33.4+_12 yrs.  19 (61%) of the subjects were males and 12 (39%) were female with ratio 1.6:1 (M: F),  20 (64.5%) were married. , 8 (40%) were endogamous married.  5 (62.5%) were second degree and 3 (37.5%) were third degree.  17 (85%) had children, 2 (10%) of the patient had children with Parkinson's disease. 22 (71%) had duration more than 12 months, 12 (39%) age more than 40 years.  29 (93.5%) had tremor, 27 (87.1%) had rigidity and 23 (74.2%) had bradykinesia. 14 (45%) had positive family history of Parkinson's disease. PINK1 gene expression was detected in 28 (90.3%) of the patients. no significant associations were found between PINK1 expression with age, gender, age at onset and family history (P> 0.05). Conclusion: This study concludes that early onset PD was common among male than female. The most affected age group was found to be 41 – 50 years and the mean age of onset 33.4yrs. Also, the patterns of the clinical features were generally similar to literature. PINK1 expression was predominant with no significant associations were found between PINK1 expression with age, gender, age at onset and family history.   Key words: , Early onset,, Parkinson's disease, Pink1 gene, Sudan

RETRACTED: Migraine headache in Sudan

Abstract Background Migraine is a main form of headache, it is also a chronic and complex neuroinflammatory disease; it is characterized by recurrent severe headaches, usually affecting one side of the head, and often accompanied by nausea and blurred vision. In susceptible individuals, irritants can trigger migraine attacks, which can be considered as triggers or accelerators. Objective To describe the precipitating factors, clinical presentation, and treatment of migraine headache in Sudanese patients. Methods This is a descriptive hospital‐based prospective study covering 130 patients during the study period from January 2016 to December 2018. At the National Centre for Neurological Science, Khartoum, participants were Sudanese patients with migraine headache after exclusion of other causes of headache. Data was collected using structured questionnaire entered and analyzed using SPSS version 22.0, p value < .05 is considered significant. Results The study covered 130 study participants most of them were females (80%), within 26–35 years of age (56.9%) and a considerable proportion of them were housewives (40%). The majority of the study participants had headache without aura in 81.5% and headache with aura in 18.5% (mainly visual type 87.5%). Photophobia and nausea were the main associated symptoms in 51.5% and 50%, respectively. Acetaminophen was the main prescribed treatment in 46.1%, beta blockers was the main prophylaxis in 29.2%. Environmental triggers were the prevalent predisposing factors (43.8%) followed by fasting, lack of sleep, and exertion (24.6% for each). Conclusion Environmental conditions were the commonest triggering factors of migraine headache, while Acetaminophen was the most common drug used for relieving migraine in this population

The pattern of neurological manifestations of tuberculosis among adult patients attending multineurological centres and hospitals in Sudan: A hospital‐based cross‐sectional study

Abstract Background Tuberculosis (TB) can involve almost any organ of the body. In the central nervous system (CNS), it can cause Pott's disease, meningitis, tuberculoma, abscess, or other manifestations. Tuberculosis is rampant in the developing world and has become a significant public health menace with the human immunodeficiency virus (HIV) dissemination. This study aimed to determine the frequency of neurological manifestations of tuberculosis among adult Sudanese patients. Methodology A hospital‐based cross‐sectional study carried out in the period from September to December 2020 at multineurological centers and hospitals in Khartoum State, including Ibrahim Malik Teaching Hospital, Alshaab Teaching Hospital, Bashier, Abu Anga, Omdurman Teaching Hospitals, included adult patients diagnosed with tuberculosis‐associated neurological manifestations. The data were collected by predesigned questionnaire, and then analyzed by computer using SPSS‐version 25. Results A total of 43 patients were evaluated, male patients were 24 (55.8%) and female patients were 19 (44.2%). About 31 (72.1%) of the participants had extra‐pulmonary TB and 12 (27.9%) had pulmonary and extrapulmonary TB. The neurological manifestations of tuberculosis include Pott's disease in 29 (67.4%) patients (with thoracic spine most affected part), tuberculoma was second‐most, occurring in 8 (18.7%) patients (with a single lesion in most of the patients), whereas tuberculous meningitis was found in 6 (13.9%). Clinical presentation was headache in 14 (32.6%) patients, convulsions in 10 (23.3%), loss of consciousness in 9 (20.9%), hemiparesis in 7 (16.3%) patients, and paraparesis in 23 (53.5%). Cranial nerve affected in 5 (11.6%) patients. All patients received antituberculosis medication and steroids, and 10 (23.2%) received anticonvulsants. Conclusions Neurological tuberculosis should be ruled out in any young male from an endemic area who exhibits abnormalities in motor, sensory, special sense, or higher mental function. To avoid potentially fatal complications, diagnoses and treatments should be initiated as soon as possible

RETRACTED: The quality of life among Sudanese patients with epilepsy, Khartoum, Sudan

Abstract Introduction This is the first study done in the National Center for Neurological Sciences, Khartoum State, to assess the quality of life among more than 100 Sudanese epileptic patients, in the period from September to December 2020. Methodology This is a descriptive cross‐sectional study; data were collected using an interview‐based semi‐structured structured questionnaire and this questionnaire was modified from the SF‐36 model. Results Most of the patients were from urban areas and origin (60.2%), most of which were housewives; the majority of the patients were single and from low socioeconomic status, history of the disease was less than 3 years for most of the cases covered in this study, most of the cases were classified as generalized tonic clonic epilepsy, and normal EEG findings and normal MRI brain were found in 75.7% and 78.6%, respectively. Most patients mentioned that they experienced no attacks during the last month. Regarding mental health, 47.6% experienced symptoms of depression, and 75.7% had memory problems. In terms of physical health, 51.5% felt energetic all of the time, 9.7% experienced remarkable sleep disturbance, most of the patients are not driving nor have established hobbies during leisure time. 63.1% of the participants do not have health problems; 32% mentioned that they would feel stigmatized if an attack takes place in public. Commonest medication prescribed was carbamazepine, out of which 73.8% are fully compliant with their medication. 95.1% are not worried about long term use of medication. Conclusion Lower levels of education and manual labor are associated with poor quality of life. Epilepsy has an adverse impact on social life. There is a global decrease in cognitive function, and most of the patients are not worried about the side effects and duration of the medication usage

RETRACTED: Neurological manifestations of COVID‐19: A potential gate to the determinants of a poor prognosis

Abstract Background Several investigations were carried out during the pandemic, demonstrating a number of neurological symptoms linked to coronavirus disease 2019 (COVID‐19) infection. Objectives The goal of this review is to discuss COVID‐19 disease's neurological signs and squeals. Methodology From December 2019 to May 2020, data were retrieved from PubMed, Scopus, and ScienceDirect, as well as a manual search using Google Scholar. COVID‐19, neurological symptoms, cranial nerves, motor system were among the key phrases utilized in the search. Results The intensity of respiratory involvement increases the likelihood of neurological symptoms and consequences. According to some research, it might range from 34% to 80%. The central and peripheral neural systems are both affected, resulting in cranial nerve palsies and limb paralysis. Conclusion COVID‐19 neurologic complications are key drivers of patient severity and mortality. Headache, convulsions, mental and psychic disorders, delirium, and insomnia are just some of the symptoms that the virus can cause. The olfactory nerve is the most commonly damaged cranial nerve, resulting in anosmia. Stroke (mostly infarction), encephalitis, meningitis, Guillain–Barre syndrome, relapse of multiple sclerosis, and transverse myelitis are all symptoms and squeals

Epilepsy awareness days, weeks, and months: Their roles in the fight against epilepsy and the intersectoral global action plan on epilepsy and other neurological disorders

Objectives: This research sought to find out the epilepsy awareness days around the world and understand the nature and role of the days in the fight against epilepsy in relation to the Intersectoral Global Action Plan (IGAP) on epilepsy and other neurological disorders (2022–2031). Methods: We conducted a review of journal articles. The databases that we searched were ProQuest Central, EBSCOhost Academic Search Complete, EBSCO Medline, PubMed Central, Wiley Online, Directory of Open Access Journals (DOAJ), African Journals Online (AJOL), and Google Scholar. We limited our search to papers of relevance to our subject published between January 2000 and January 2023. We searched ‘epilepsy awareness day, week, or month’. From the databases, 13 articles met our inclusion criteria. We augmented our results with a search on Google of articles about epilepsy awareness day, week, or month. We also searched directly on the websites of epilepsy organizations. Results: We found that epilepsy awareness days fall into these categories: global awareness days (n = 2), awareness months (n = 4), regional awareness weeks (n = 5), and regional awareness days (n = 1). Our search for national awareness days (n = 7) was not comprehensive, and this could be an area for future research. The literature shows that epilepsy awareness days could play a role in (1) reducing knowledge and treatment gaps, (2) increasing participation, (3) unlocking resources, and (4) necessitating policy change and increasing networking. The major role of these dedicated days in the IGAP is to accelerate awareness and advocacy for policy change and improved interventions. Conclusions: Epilepsy awareness days are bringing stakeholders together already, and IGAP initiatives could tap into this achievement to accelerate awareness in a cost effective, contextual and collaborative manner. This could be achieved by adopting themes that relate more directly to the IGAP goals. Another important strategy is to motivate countries that do not have national epilepsy days or regions that do not have a regional awareness days, to consider doing one within the confines of resources

Parkinsonism Relat Disord

Background: Several studies suggested a significant role of epigenetic changes, including alterations in miRNA, histone modifications, and DNA methylation of α-synuclein (SNCA) in Parkinson’s disease (PD) pathogenicity. As of yet, only very few studies have been carried out in this field in Africa and none in Sudan. Materials and methods: We collected DNA from 172 Sudanese individuals (90 cases, 82 controls) who donated saliva for DNA extraction (mean age of onset: 40.6 ± 22.4 years). A family history of PD was evident in 64 patients. DNA preparation and bisulfite sequencing of SNCAintron1 was performed as described earlier. Results: Of the fourteen analyzed CpGs of SNCAintron1, CpGs 16-23 were hypomethylated in PD (P-value ranged from 0.023 to 0.003). P–values improved, when sporadic cases were excluded from the analysis. Conclusion: We identified the presence of a specific pattern of DNA methylation in a young Sudanese cohort of familial PD, which confirms the importance of the methylation of SNCAintron1 for PD. This phenomenon appears to be independent of ethnicity, the impact of environmental factors, drug history, or familial clustering