Editorial – Digital Transformation in Higher Education Institutions in a Limited-resource Setting: A Luxury or a Must Despite Challenges?

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Editorial – “Together We Build Our Health”: Paving Way Forward Through Analyzing the Context and Ensuring Wide Participation in the First and Second Health Forums in Sudan

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Editorial – War in Sudan: The Impact on Maternal and Perinatal Health

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Editorial – Confronting Challenges and Proposed Solutions for the Sudan Immunization Program Amid Ongoing Armed Conflict

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Changes in Serum Iron, Total Iron Binding Capacity and Transferrin Saturation Percent in Sudanese Females Newly Diagnosed with Breast Cancer at Khartoum Oncology Hospital: A case- control study

Background:Iron is a vital constituent of cells but in excess may be harmful and is associated with a raised risk for some malignant diseases including breast cancer. We aimed to study changes in iron profile in Sudanese females newly diagnosed with breast cancer.Methods: A case- control study in which serum iron, Total Iron Binding Capacity (TIBC), and transferrin saturation percent were measured for fifty females with breast cancer referred to Khartoum Oncology Hospital and seventy apparently healthy females, using manual method (IRON-FERROZINE).  Results: Mean age was 47years and 42years in cases and control, respectively and the mean of parity was 4 in both groups. Mean of serum iron ±SD in case group was 244.30 ± 151.598(µg/dL)and in control group was 57.59 ± 43.191(µg/dL) (P. value = 0.000). Mean of TIBC ±SD in cases was 412.98 ± 177.460(µg/dL)and in controls it was 403.71 ± 168.765(µg/dL) (P.value = 0.838). The mean of transferrin saturation percent ± SD in cases was 61.08 % ±41.523 and in controls was 223.23 % ±149.195 (P.value=0.000). The mean of TIBC in grade I 343.00(µg/dL), 467.10(µg/dL) in grade II and 321.25(µg/dL) in grade III (P.value 0.019).Conclusion: There is a statistically significant increase in the mean of serum iron and decrease in transferrin saturation percent in women with breast cancer. TIBC vary significantly according to histopathological grade. Serum iron and transferrin saturation percent may be helpful as biochemical risk markers for breast cancer and TIBC may act as a predictor of disease grade

Coagulation profile of Sudanese children with homozygous sickle cell disease and the effect of treatment with omega-3 fatty acid on the coagulation parameters

Background: It has been reported that patients with SCD do have an abnormal coagulation profile. Coagulopathy is thought to be one of the key factors that contribute to the vaso-occlusive crisis that characterises sickle cell disease (SCD). In this study, we investigated whether Sudanese sickle cell patients have an abnormal coagulation profile. In addition, the effect of treatment with either omega-3 fatty acids or hydroxyurea on coagulation profile was assessed. Methods: Homozygous SCD patients untreated (n = 52), omega-3 treated (n = 44), hydroxyurea (HU) treated (n = 8) and healthy (HbAA) controls (n = 52) matched for age (4–20 years), gender and socioeconomic status were enrolled. Patients on omega-3 fatty acids, according to age, received one to four capsules containing 277.8 mg DHA and 39.0 mg eicosapentnoic. Patients on Hydroxyurea were in on dosage more than 20 mg/kg/day. The steady state levels of the coagulation parameters and the effect of the treatments with either HU or omega-3 fatty acids on markers of coagulation were investigated. Results: Compared to the healthy controls, treated and untreated HbSS patients had lower hemoglobin, plasma Protein C, proteins S and higher white blood cell count (WBC), platelets count (PLTs) and plasma D-dimer levels,(p 0.05). HU treated group had a lower PLTs count compared to HbSS untreated group (p < 0.5). The prothrombin and activated partial thromboplastin times and international normalized ratio (INR) of untreated patients are significantly higher than n-3 treated, HU-treated patients and health controls, (p < 0.05). Patients treated with omega-3 had lowered D-dimer levels in comparison to HU-treated and untreated HbSS patients, (p < 0.001). Conclusion: This study provides evidence that Sudanese patients have abnormal coagulation profile and treatment with either HU or omega-3 fatty acids might partially ameliorate SCD-associated chronic coagulopathic state. Keywords: Sickle cell disease, Coagulation, Omega-3 fatty acids, D-dimer, Protein C, Protein

Type of High Secondary School (Governmental Vs Private) and Type of High Secondary School Certificate (Sudanese Vs Arabian): Do They Affect Learning Style?

Background: People differ in the way they perceive, process, store, and recall what they are attempting to learn. This study aimed to assess the learning styles among preclinical 1st year medical students and the influence of the type of high secondary school (governmental vs. private) and type of high secondary school certificate (Sudanese vs. Arabian) on learning style.Materials and Methods: A cross sectional institutional-based study was conducted at Al Neelain University, Khartoum State, Sudan. First year students of Medicine, Dentistry and Physiotherapy Faculties were enrolled. The VARK (Visual, Auditory, Read and write, and Kinesthetic) learning style hard copy questionnaire, © Copyright Version 7.8 (2014) held by VARK Learn Limited, Christchurch, New Zealand was administered following permission. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21.Results: Out of 320 students, 198 correctly completed VARK questionnaires, with mean age of 17.88 years (SD 1.52) and 74.2% were female students. About 59.6% were from governmental schools and 79.4% of the studied students had Sudanese High Secondary Certificates. About 64.1% demonstrated singular mode preference. Inferential statistics showed statistically significant difference between the learning styles and the type of secondary school whether governmental or private (P-value 0.005) while no statistically significant difference in relation to the type of high school certificate of the studied group (P-value 0.225).Conclusion: The type of secondary school whether governmental or private may affect learning style of medical students while student's gender, type of college, or type of high school certificate (whether Sudanese or Arabian) do not. More andlarger studies are encouraged.Key word: Learning modalities, VARK questionnaire, Unimodal preference, Medicaleducation, Sudan

Prognostic Significance of Vascular Endothelial Growth Factor (VEGF) and Her-2 Protein in the Genesis of Cervical Carcinoma

BACKGROUND: Angiogenesis plays a pivotal role in the progression of tumours through the formation of new blood vessels. Vascular endothelial growth factor (VEGF) is a chief factor responsible for inducing and regulating angiogenesis. Additionally, the human epidermal growth factor receptor family of receptors also plays an important role in the pathogenesis of tumours.AIM: This study aimed to examine the association between VEGF and Her-2 protein expression and its correlation with clinic-pathological characteristics; in particular, prognosis.METHODS: A total of 65 cases of cervical carcinoma and 10 samples of inflammatory lesions were evaluated for VEGF and Her-2 protein expression.RESULTS: Expression of VEGF and Her-2 was detected in 63.07% and 43.07% in cervical carcinoma cases respectively whereas control cases did not show any expression. The difference in the expression pattern of both markers comparing cancer and control cases was statistically significant (p &lt; 0.05). However, no significant difference in the expression pattern of VEGF protein was observed among the different grades and stages of tumours (p &gt; 0.05). Comparing different grades of a tumour, expression of Her-2 was detected in 31.8% of well-differentiated tumours, 36.0 % in moderately differentiated tumours and 66.66 % in poorly differentiated cancers. The expression of Her-2 was increased in high-grade tumours, and the difference of expression level between tumour grades was statistically significant (p &lt; 0.05). The expression level of Her-2 protein was not correlated with the stage of a tumour (p &gt; 0.05).CONCLUSION: The present study supports earlier findings that over-expression / up-regulation of VEGF and Her - 2 is linked with poor prognosis and may play a vital role in the development and progression of cervical cancer

Association between Exposure to Beta 2 Agonists and Corticosteroids and Acquiring Benign Joint Hypermobility Syndrome among Asthmatic Patients: a Case-Control Study

Background:Beta2 (β2) agonists as relievers and corticosteroids as controllers are the mainstay drugs for asthma treatment. Benign Joint Hypermobility Syndrome (BJHS) is a connective tissue disorder with musculoskeletal symptoms.We had examined the possible association between the use of β2 agonists and corticosteroids and acquiring BJHS in asthmatic patients.Methods:This was a case-control, hospital-based study including a group of asthmatics who had BJHS (cases), compared with a matched group of asthmatics without BJHS (controls) for the β2 agonists and corticosteroids past and current pattern of use. Information was collected by face-to-face interview and clinical examination and from subjects’ medical records using pre-structured questionnaire. BJHS diagnosis was based on the revised Brighton criteria. Asthma severity was reflected by a score, which was calculated from the asthma questionnaire. Comparison of exposure was done by Calculation of Odds Ratio.Results:Development of BJHS was found to be significantly associated with chronicity of asthma of average duration of 13.2 years, and hence to prolonged use of β2 agonists and/or corticosteroids (OR 1.019; 95% CI 0.999 - 1.039, P=0.006)Exposure to β2 agonist and corticosteroid (87 and 79 cases and controls respectively P=0.05)high asthma score (42.9 ± 9.8 and 40.4 ± 8.3 among cases and controls respectively, P=0.011) were significantly associated with the development of BJHS

Clinicopathological Significance of Vimentin and Cytokeratin Protein in the Genesis of Squamous Cell Carcinoma of Cervix

Cervical cancer is one of the commonest types of cancers worldwide especially in developing countries. Intermediate filaments protein family has shown a role in the diagnosis of various cancers, but a few studies are available about the vimentin and cytokeratin roles in the cervical cancer. This case control study aimed to interpret the expression of vimentin and cytokeratin proteins in the development and progression of cervical cancer and its correlation with clinicopathological features. The cytoplasmic expression of vimentin was observed in 40% of cases, but not in inflammatory lesions of cervix. It was noticed that vimentin expression was increasing significantly with high grade of the tumour. Cytokeratin expression was observed in 48.33% and it was noticed that the expression was 62.5% in well differentiated (G1), 45% in moderately differentiated (G2), and 41.66% in poorly differentiated carcinoma, yet statistically insignificant. The expression of vimentin and cytokeratin proteins was not significantly associated with age groups. The current findings concluded a possible role of vimentin in the development and progression of cervical cancer and vimentin marker will be useful in the diagnosis and grading of cervical cancer