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Mycetoma is classified as a neglected tropical disease, and despite its spread in Sudan, most physicians and pharmacists do not pay attention to the symptoms and proper treatment of mycetoma. Thus, this study aimed to evaluate knowledge and practice on mycetoma among community pharmacists in Khartoum state. A cross-sectional descriptive study was carried out among community pharmacists in Khartoum state, in the period from August to October 2021. Data was collected from the seven localities within Khartoum state using a validated self-administered questionnaire. The knowledge and practice of community pharmacists were assessed, and their association with demographic characteristics was calculated. Out of 347 pharmacists, 59.9% were females, 64.8% were between 22 and 28 years of age, and 79.3% were bachelor holders. Most of the participants (52.7%) had sufficient knowledge about mycetoma, the most common source of information was lectures (36.6%), more than half participants heard about the Mycetoma Research Center, and most of the cases seen by the participants were in the community (30.5%). There was no association between demographic data and knowledge score, except for knowing about the Mycetoma Research Center and attending workshops and seminars. Moreover, more than half of the participants showed good practice with mycetoma patients. The findings of the current study reflect that more efforts are needed to increase the knowledge and improve the practice of community pharmacists toward mycetoma.

Abstract Background Coronavirus disease 2019 (COVID-19) is a pandemic caused by a newly discovered coronavirus. Although clinical manifestations of COVID-19 are mainly pulmonary, some patients have other systemic manifestations. This study aimed to describe the clinical finding and outcomes in Sudanese patients diagnosed with COVID-19. Methods This retrospective observational study is based on documented files that included patients diagnosed with COVID-19 in seven selected hospitals inside Khartoum. Clinical manifestations, complications and outcomes were extracted from patients’ records using an extraction form designed for this study. Results Data of 243 patients diagnosed with COVID-19 were analyzed. The mean (SD) age in years was 55.8 (18.4). Out of 116 participants, 27 of them (23.3%) had severe disease, 15 (12.9%) were critically ill. 67.5% of patients were admitted to the hospital within 7 days from onset of symptoms; most of them were admitted to the wards (n = 140,72.5%). Fever (83.2%), cough (70.7%), and shortness of breath (69.2%) were the most commonly recorded clinical manifestations. Sepsis (9.8%) and acidosis (7.8%) were the most frequently reported complications. Death was the final outcome in 21.4% (56/243). Older age and presence of diabetes were found significantly associated with in-hospital death. The laboratory results showed high CRP in 85.6% (119/139), high ferritin in 88.9% (24/27), lactate dehydrogenase had a median of 409.0 (359–760), D-dimer had a median of 3.3 (1.2–16. 6), and 53/105 (50.5%) had low albumin. Conclusions Fever was the most mentioned sign among the participants, followed by fatigue. Cough and shortness of breath were the most commonly recorded pulmonary symptoms manifested. Our study showed multiple variables were associated with in-hospital death. The mortality rate was high among severe and critically ill patients diagnosed with COVID-19.

Background: Lower extremity amputation (LEA) in individuals with diabetes is a serious health issue with a considerable physical and social burden. The aim of this study was to assess the prevalence and risk factors associated with LEA in diabetic foot ulcer (DFU) patients. Materials and Methods: This was a cross-sectional health facility-based study that recruited 315 diabetes individuals with foot ulcers from the diabetes center in Khartoum, Sudan. Direct interviewing of subjects was used to obtain data, using a standardized validated questionnaire. Chi-square and logistic regression analysis were used in data analysis. Results: 69.5% of the diabetic participants were aged 50 years old or more, and 71.1% were males. Most of the subjects (48.2%) were diabetics for a duration of >10 years, while more than one third (37.5%) of them were diabetic for 5–10 years. The majority (89.5%) had type 2 DM, while only 10.5% were type 1 DM. Two hundred forty-five patients had a left lower foot ulcer; 55.1% of the patients' ulcers were present in the toes, while 21.6% were in the foot sole. The overall prevalence of lower limb amputation was 17.1%. Individuals with diabetes patients with LEA had a higher incidence of hypertension (P = 0.000), retinopathy (P = 0.000), nephropathy (P = 0.002), ulcer size >2.5 cm (P = 0.000), and neuropathy (P = 0.000) through Chi-square analysis. Furthermore, logistic regression analysis showed that amputation was significantly associated with retinopathy (P = 0.000), size of ulcer (P = 0.000), and neuropathy (P = 0.016). Conclusion: The overall prevalence of LEA was 17.1%. The primary risks factors associated with amputation were presence of neuropathy and ulcer size >2.5 cm. Presence of retinopathy predispose diabetic individuals to amputation. Amputation is associated with disability and psychological problems; therefore, there is an urgent need for more improvement in preventative measures and primary health care system in low resource setting country like Sudan in order to decrease diabetes complications, especially patient's education about diabetes management by primary care physicians.

INTRODUCTION: Diabetes complications in Sudan were increasing at an alarming rate. The aim of this study was to assess the prevalence of stroke among Sudanese individuals with diabetes. METHODOLOGY: This cross-sectional study recruited 283 individuals with diabetes from three diabetes centers in Sudan. Data were collected using a standardized pretested questionnaire, and data were analyzed using Chi-square and logistic regression analysis. RESULTS: The average age of participants was 51 (±12 standard deviation) and 35% were aged between 51 and 60 years. Females were 66.8%, and most of the participants (73.9%) were from urban areas and 66.1% received formal education between primary school and university. Body mass index (BMI) classification showed that 34.3% were obese, 31.8% overweight, and 30.4% normal BMI. Diabetes for 1-5 years were observed in 71.7% and for more than 10 years (12%). The majority, i.e., 94.3% had type 2 diabetes mellitus while only 5.7% had type 1. Only one-third of the participants were able to achieve glycosylated hemoglobin (HbA1c) target for diabetes control. The prevalence of cerebrovascular accident (CVA) was 2.5%, hypertension (HTN) was 20%, ischemic heart disease 3.2%, and neuropathy was 45.6%. Chi-square test showed significant association between HbA1c, serum creatinine, total cholesterol, triglyceride, low density lipoprotein, high density lipoprotein level, and the presence of CVA. Logistic regression analysis showed HbA1c, and the duration of diabetes are significantly associated with the presence of CVA (P = 0.010, 0.014). CONCLUSION: The prevalence of stroke among Sudanese individuals with diabetes was around 2.5%. The main risk factors were HbA1c, HTN, and duration of diabetes.

Background: Depression is the most common prevalent psychiatric condition among patients with chronic kidney disease (CKD), and especially during dialysis. This study aimed to evaluate depression symptoms in Sudanese patients with end-stage renal diseases (ESRD) who undergo hemodialysis. Methods: This is a case finding, hospital-based study recruited 75 patients on dialysis in Khartoum, Sudan. Data were analyzed by statistical package for social science (SPSS, version 23). Results: The percentage of depression symptoms that satisfies the criteria for the diagnosis of major depression disorders in patients with ESRD undergoes dialysis was 68%. The new patients who undergo dialysis for less than 1 year had more depression symptoms (66.7%) than those on dialysis for 2–3 years (21.6%) or more than 3 years with a percentage of11.8%. Chi-square test showed significant associations between depression and age, the duration of dialysis, signs of significant weight loss when no dieting, and when the clinical symptoms related to distress or social or functional impairment (P = 0.016, 0.000, 0.004, and 0.000, respectively). Logistic regression test showed that age and duration of dialysis were significantly associated with depression with (odds ratios [OR]: 0.724, 0.211) Conclusion: More than two-thirds of patients on dialysis have depressive symptoms. Risk factors associated with depression in Sudanese patients on dialysis were age, duration of dialysis, weight loss, and social and functional impairment. Future research is needed in order to assess the benefit of antidepressants in patients on dialysis. Family physicians should be aware of the association between depression and dialysis, in order to provide early treatment and prevent suicide.

Background: Prediabetes is an important stage before diabetes that can be treated with intensive lifestyle changes. The aim of this study was to assess knowledge, attitudes, and practice of primary care physician in Sudan about prediabetes. Methods: A cross-sectional questionnaire-based study was conducted among primary care physicians working at two family and primary health care centers in Khartoum. Data were analyzed using descriptive statistics and expressed as percentages. Results: Out of 200 primary care physicians, 189 completed the questionnaire. 60.8% of the participants had satisfactory knowledge about prediabetes and positive attitude towards prediabetes and their practice was relatively good. Knowledge score was significantly correlated with age (P = 0.000), duration of experience (P value = 0.000), the number of working hours per day (P value = 0.001), and the number patients seen per day (P value = 0.001). Logistic regression analysis showed that attending courses relevant to prediabetes revealed statistically significant result in knowledge, and attending such courses were likely to be associated with gaining sufficient knowledge than those who didn't by 2 times (P value 0.033, OR 2, CI. 1.063-4.079). Conclusions: Primary care physicians in Sudan have satisfactory knowledge, attitude, and practice about prediabetes. As they are in the front line in dealing with community, primary care physicians' efforts can help in slowing down the epidemic of diabetes in Sudan.

BACKGROUND: Inadequate lifestyle practices among individuals with diabetes may influence the progression of diabetes and its complications. The aim of this study was to assess the lifestyle practices among individuals with diabetes in Sudan. METHODOLOGY: This was a descriptive, cross-sectional, health facility-based study conducted in 3 diabetes centers treating individuals with diabetes. The data were collected using a standardized pretested metabolic questionnaire about lifestyle and were analyzed by performing descriptive and inferential statistics through SPSS program version 23. RESULTS: A total of 528 patients with diabetes answered the questionnaire. There were 52.1% of female participants and 72.9% of urban residents. 23.9% were obese, regular exercise was reported by 27.7%, and no exercise by 17%. There was a statistically significant association between lifestyle practices and gender (P < 0.001), age (P < 0.001), educational level (P = 0.002), marital status (P < 0.001), duration of diabetes (P < 0.001), hypertension (P < 0.001), high-density lipoprotein (P < 0.001), low-density lipoprotein (P < 0.001), and HbA1c level (P < 0.001). Logistic regression analysis showed male gender and education were significantly associated with lifestyle changes. Men were more likely to engage in favorable lifestyle practices than women (P < 0.001), while those with no formal education were less likely to engage in healthy lifestyle (P < 0.001). CONCLUSIONS: Health authorities in Sudan will need to put more efforts into education for promoting self-awareness and good lifestyle practices in the population with diabetes.