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Eumycetoma, a chronic fungal infection caused by Madurella mycetomatis, is a neglected tropical disease characterized by tumor-like growths that can lead to permanent disability and deformities if untreated. Predominantly affecting regions in Africa, South America, and Asia, it imposes significant physical, social, and economic burdens. Current treatments, including antifungal drugs like itraconazole, often show variable efficacy, with severe cases necessitating surgical intervention or amputation. Drug discovery for eumycetoma faces challenges due to limited understanding of the disease's molecular mechanisms and the lack of 3D structures for key targets such as Madurella mycetomatis CYP51, a well-known target for azoles' antifungal agents. To address these challenges, this study employed computational approaches, including homology modeling, virtual screening, free energy calculations, and molecular dynamics simulations, to repurpose FDA-approved drugs as potential treatments for eumycetoma targeting Madurella mycetomatis CYP51. To this end, a library of 2619 FDA-approved drugs was screened, identifying three promising candidates: montelukast, vilanterol, and lidoflazine. These compounds demonstrated favorable binding affinities, strong interactions with critical residues of the homology model of Madurella mycetomatis CYP51, and stability in molecular dynamics simulations, offering potential for further investigation as effective therapeutic options for eumycetoma. [ABSTRACT FROM AUTHOR]

Introduction: The spread of multidrug-resistant pathogens is a major global health concern. A survey was conducted to evaluate the knowledge and attitudes towards antimicrobial use and resistance in Sudan. Methodology: A cross-sectional survey with a 39-item questionnaire was distributed via social media platforms to Sudanese residents in Khartoum state. Responses were collected anonymously from April to October 2022 and subjected to statistical analysis to assess associations between variables. Results: A total of 1,037 participants agreed to participate, with a 94.3% response rate. Two-thirds of participants reported using oral antibiotics in the past 12 months. Only a quarter obtained antibiotics with a prescription. Less than half (45.3%) of the participants underwent diagnostic tests before using antibiotics, and 30.2% adjusted or discontinued the antibiotic dosage. Forty-two percent correctly identified that antibiotics are ineffective against viral infections, but confusion regarding their use persisted. The mean knowledge score was 3.3 ± 1.7, indicating average knowledge levels. Significant variations in knowledge and attitudes were observed based on age, gender, marital status, and education. The mean score of the participants' attitude was 25.5 ± 3.97. Female, younger, and single participants exhibited more positive attitudes towards antibiotics use and resistance. Conclusions: The participants exhibited average knowledge levels and mixed attitudes towards antibiotic use and resistance. Misconceptions and inadequate indications for antibiotic use were identified. Gender, age, marital status, and education influenced participants' knowledge and attitudes. These findings can inform strategies to promote appropriate practices and combat the spread of antibiotic resistance across health and non-health sectors. [ABSTRACT FROM AUTHOR]