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Graphical abstract, Highlights • This work proposes a new generalized formulation for the optimal power flow. • The proposed formulation is suitable for real-time energy management systems. • Unlike previous research, the proposed formulation tackles practical unbalanced systems. • Detailed analysis with simulation results of the proposed formulation are provided. • The proposed approach is characterized by scalability and low computational time., This paper presents a new generic approach for developing a Jacobian matrix for use with the optimization unit in real-time energy management systems (EMS) for unbalanced smart distribution systems. The proposed formulation can replace approximated calculations for real-time optimal power flow in an optimization unit while providing greater accuracy and requiring less computational time, which is critical for real-time EMS. The effectiveness and robustness of the proposed approach have been tested through simulations with different distribution networks. The simulation results demonstrate a significant reduction in the computational time with the new proposed formulation. Moreover, the results demonstrate the scalability of the proposed approach as the reduction in the computational time is more significant for large practical systems. The proposed approach is characterized by evaluating the scalability and low computational time; thus, it can be used by grid operators in real-time energy management applications for large-scale practical distribution systems.

The analytical solution of a three-level atom interacting with four systems of N-two-level atoms is studied. The atomic inversion and the correlation function as applications of this model are discussed. In addition, the effects of the quantum numbers and the coupling parameters between spins on the atomic inversion and the correlation function are investigated. The analysis of results manifests that correlated behavior can be controlled by adjusting the coupling parameters between spins. Besides, we can use parameters as controller, by which the required behavior, whether classical or non-classical, is identified.

Administrative empowerment is a critical process for the employees, as it is a contemporary concept that leads the employee to achieve high levels of collaboration, teamwork, self-confidence, creativity, independent thinking and entrepreneurship. In general, the hotel managers play an important role in empowering their employees by giving them the information and responsibilities of the work, as well as, providing an atmosphere of trust between the management levels that help employees in decision-making. Additionally, administrative empowerment gives employees more flexibility and empowerment that help them to improve their performance and loyalty to the work. The study aims to identify the extent of the implementation of administrative empowerment of the employees in five-star resorts in Hurghada City, and its impact on job satisfaction. The study sample consists of employees of the five-star resorts in Hurghada City. This research is applied in 23 resorts of Hurghada City in Egypt. It adopts a quantitative approach for achieving its aims and desired objectives. A convenient sample was selected consisting of 500 hotel staff with an average of 72.4% response rate. A questionnaire is used for collecting data which is later analysed using SPSS version 24. The results indicate that administrative empowerment and its dimensions have a positive effect on job satisfaction. According to the results, the study proves that there is a strong correlation between administrative empowerment and employee's satisfaction in the five-star resorts in Hurghada City. It also recommends that hotel resorts empower and strengthen their employees by trusting in them, giving them the authority to carry out their tasks without consulting the administration, encouraging teamwork and providing them with appropriate training programs as well as communication channels for contacting with senior management. This study contributes to identifying the concept of administrative empowerment, its importance and dimensions as well as enriching the studies on the relation between administrative empowerment and its impact on job satisfaction. However, there is a lack of studies that show the effect of administrative empowerment on job satisfaction in the resorts in Egypt, especially in Hurghada resorts.

There has been much increased interest in the academic and industrial research communities on vehicular ad-hoc networks (VANETs). In this paper, we present an analytical model to study the end-to-end delay in a one-way VANET. This paper proposes an analytical formula for the end-to-end delay probability distribution. Using the derived probability distribution, the probability that the end-to-end delay is lower than a given threshold may be calculated. In addition, one can straightforwardly study the impact of parameters such as wireless communication range, vehicular densities, distance between source the destination, and minimum and maximum vehicle speeds on the end-to-end delay. This can help to better understand data dissemination in VANETs. Moreover, closed forms for lower and upper bounds on the end-to-end delay probability distribution are obtained. Extensive simulation results demonstrate the accuracy of our analysis.

A total number of one hundred and eighty Japanese quail birds (120 females and 60 males), 9-weeks old were randomly divided into five groups, 36 birds each and each treatment was replicated four times with 9 birds in a completely randomized design. Dietary treatments were as follows: basal diet only without supplementation and served as a control group, basal diet + 100 mg Tylosine /kg diet, basal diet + 250 mg licorice /kg diet, basal diet + 500 mg licorice /kg diet and basal diet +1000 mg licorice /kg diet. The results showed that dietary supplementation with different feed additives had insignificant effect on egg laying rate, egg number, average egg weight, egg mass and feed conversion ratio compared with control group. The percentage of egg shell thickness was significantly (P ≤ 0.001) increased by supplementation with Tylosine and licorice in compare with control group. Serum total lipids, total cholesterol and low density lipoprotein (LDL) were significantly (P ≤ 0.001) decreased due to addition of different feed additives. Yolk total lipids was significantly (P ≤ 0.001) decreased with dietary supplementation of licorice root powder and Tylosin in the diets. Also, significant (P ≤ 0.01) decrease in egg yolk cholesterol was recorded in the group fed with 500mg licorice in comparison with anther treatments. In conclusion, dietary inclusion of licorice powder could be applied as alternatives to in-feed antibiotics for laying Japanese quail diets.

Eighty multiparous lactating Holstein cows (635 ± 33 kg) were used to study the effect of feeding Saccharomyces cerevisiae and/or Aspergillus oryzae on lactational performance for 14 weeks. Cows were assigned in a completely randomized experimental design, with repeated measures into four treatments, and were fed a basal diet of concentrates and forage at a ratio of 592:408, respectively. The treatments were: (1) the basal diet with no additive (Control treatment); (2) the basal diet supplemented with 3.5 g of live S. cerevisiae/cow daily (SC treatment); (3) the basal diet supplemented with 3.5 g A. oryzae fermentation extract/cow daily (AO treatment); and (4) the basal diet supplemented with 3.5 g of live S. cerevisiae + 3.5 g A. oryzae fermentation extract/cow daily (AOSC treatment). The AO and AOSC treatments increased (p

Machine-type communications (MTC) play an important role in implementing and enabling the Internet of Things. Long -term evolution (LTE) is a strong candidate technology for the interconnection of the MTC devices. However, to optimize LTE for MTC purposes, several issues need to be addressed. This is due to the different and diverse quality of service (QoS) requirements of MTC compared to those of human-to-human (H2H) communications. In particular, critical-MTC pose many challenges to radio resource management in LTE. They have stringent QoS requirements that need to be considered without sacrificing the QoS of the H2H traffic. In this paper, we formulate the resource allocation optimization problem from a cross-layer design perspective to consider both the QoS requirements of critical-MTC and those of H2H communications. We propose methods to handle the optimization problem to reduce the computational complexity of the optimal solution. Additionally, the performance of the proposed resource allocation algorithms is evaluated analytically. Moreover, more computationally efficient algorithms are proposed to practically implement the resource allocation process in several operational cases. Finally, the computational complexity of the proposed algorithms is analyzed. The simulations results show the superiority of the proposed algorithms and methods compared to other techniques from the literature.

The LLC resonant converter can achieve soft switching over a wide operating range, making it a suitable candidate for high-efficiency dc-dc conversion, even at a high output current. We applied enhancement-mode gallium nitride (eGaN) fieldeffect transistor (FET) technology to a 1-MHz, 900-W LLC resonant converter in a fixed 4:1-ratio dc-dc transformer application operating with a 48-12-V conversion suitable for data-center applications. The converter achieves power efficiency and density density exceeding 98% and 1,500 W/in3, respectively, with excellent thermal performance.

Background Paroxysmal movement disorders are interesting forms of hyperkinetic movement disordersthat are perplexing to the neurologist and patients. The main features are transient dystonia or choreainvolving various body parts and lasting few seconds, minutes or hours depending on the subtype. Theparoxysmal exercise-induced dyskinesia is associated with a gene mutation of (NM_145239.2:c.649dupC)in proline-rich trans-membrane protein 2 (PRRT2). This is found in an average of 45% of cases. Familialcases have 85% penetrance.Case report We report a case of a 12-year old boy with intermittent episodes of abnormal movementswhich involved his face and / or limbs. These dyskinesias occur every few days without warning.Complete neurological examination was normal. Importantly, Magnetic Resonance Imaging head andElectroencephalography were normal in association with normal haemto-biochemistry profile. The familyrecorded a video for one episode of his abnormal movement. The doctor set a challenge of 20 meters racing.He excited the patient then started the race with the attendance of the parents and the nurse. Few secondsafter the end of the race the development of the abnormal movement was judged by the parents and nursewho all agreed on the provocation test.Conclusion Paroxysmal exercise-induced dyskinesia is the commonest primary episodic movementdisorder which has its negative effect on the quality of life. The diagnosis and management are mainlyclinical. It is of paramount importance to use simple tests (exercise test) and save the patient unnecessaryworries and side effects of medications.

IntroductionIn countries with weak surveillance systems confirmed COVID-19 deaths are likely to underestimate the death toll of the pandemic. Many countries also have incomplete vital registration systems, hampering excess mortality estimation. Here, we fitted a dynamic transmission model to satellite imagery data on burial patterns in Mogadishu, Somalia during 2020 to estimate the date of introduction, transmissibility and other epidemiologic characteristics of SARS-CoV-2 in this low-income, crisis-affected setting.MethodsWe performed Markov chain Monte Carlo (MCMC) fitting with an age-structured compartmental COVID-19 model to provide median estimates and credible intervals for the date of introduction, the basic reproduction number (R0) and the effect of non-pharmaceutical interventions in Mogadishu up to September 2020.ResultsUnder the assumption that excess deaths in Mogadishu February-September 2020 were directly attributable to SARS-CoV-2 infection we arrived at median estimates of October-November 2019 for the date of introduction and low R0 estimates (1.3-1.5) stemming from the early and slow rise of excess deaths. The effect of control measures on transmissibility appeared small.ConclusionSubject to study assumptions, a very early SARS-CoV-2 introduction event may have occurred in Somalia. Estimated transmissibility in the first epidemic wave was lower than observed in European settings.

In recent years, non-linear loads on the distribution side are increasing rapidly. Notably, the electric arc furnace (EAF) is the most used non-linear load due to its diverse applications for industrial needs. However, EAF has some disadvantages like uneven distribution of heat inside the furnace, release of unwanted gases, increased level of harmonics, and Flickers in voltages. Specifically, power quality concerns are more and need comprehensive solutions. In this work, a matrix converter (MC) along with static VAR compensator (SVC) is proposed, and the hybrid exponential-hyperbolic furnace model is adapted in MATLAB platform. Simulations are carried out for different cases and the observed results are compared with existing methodologies. It was perceived that the power quality parameters such as peak current and voltages, total harmonic distortions (THDs), voltage flickers, and power factors are enhanced compared with existing methodologies. Precisely, the THD of current and voltage attains a prime rate of about 2.85% and 29.54%, respectively. Moreover, the proposed model’s voltage flicker and power factor offer a grander scale of about 1.26% and 0.9975, respectively. The enhanced scheme provides more significant advantages to the large-scale steel manufacturing plant with EAF.

Background and study aim Endoscopy is the gold standard investigation for diagnosis of gastroesophageal varices (GOVs), yet it is invasive, associated with complications. Many noninvasive parameters were investigated to predict the presence of GOVs. The current study investigated gallbladder wall thickening (GBWT) measurement as a noninvasive predictor of GOVs in posthepatitic cirrhotic patients with portal hypertension. Patients and methods In this cross-sectional study, 105 cirrhotic patients were divided into, group I and II according to the presence or absence of GOVs, respectively. Group I subdivided into, groups A and B according to the grade of GOVs either nonadvanced (grades I and II) or advanced (grades III and IV), respectively. Complete history taking, full clinical examination, full investigations, upper endoscopy and abdominal ultrasonography were performed to examine all patients. Results Both groups were comparable in their baseline characteristics except for AST to Platelet Ratio Index and Fibrosis-4 scores, which were significantly higher in group I. GBWT, portal vein diameter and spleen length were significantly associated not only with GOVs but also with its advanced grades. GBWT at a cutoff level >3.1 mm can predict the presence of GOVs with 54.29% sensitivity, 97.14% specificity, 97.4% positive predictive value (PPV), 51.5% negative predictive value (NPV) and 68.5% accuracy. GBWT can predict advanced grades of GOVs at a cutoff level >3.5 mm, with 45% sensitivity, 90% specificity, 64.3% PPV, 80.4% NPV and 77.1% accuracy. Conclusion GBWT was associated with the presence of GOVs, and with advanced GOVs in posthepatitis cirrhotic patients with portal hypertension.

Background and study aims: Inflammatory bowel disease (IBD) is a chronic inflammato­ry and destructive disease of the bowel wall. Chronic inflammation is associated with ulcerations, strictures, perforations and is a risk factor for dysplasia and cancer. To reduce these long-standing complications, IBD patients are continuously in a need for treatment and monitoring. Primary health care centers lack specific IBD management facilities although they receive a reasonable number of IBD patients. Markers, such as ESR, CRP, fecal calprotectin (FC) have been widely used as noninvasive parameters for IBD monitoring. The aim of the current study was to evaluate readily available non-invasive tests (FC, ESR, Platelets, serum total proteins, serum albumin and hemoglobin level) in predicting IBD activity and severity in the primary health care‎‎‎. Patients and Methods: This prospective study included 96 newly diagnosed IBD patients. Patients from many primary health care ‎centers covering the landscape of Kafr-Elshikh governorate in the North of Egyptian Nile delta after giving ‎complete history, clinical examination, and laboratory investigation were referred to IBD clinic at ‎Kafrelsheikh University Hospital for assessment and ileoclonoscopy with biopsies‎.‎ Results: Seventy-eight (81.2%) patients were ulcerative colitis and 18(18.8%) were Crohn's disease, with mean age ‎was 34.40 and 30.94 years respectively (P 0.380).FC, serum total proteins, ESR and HB level showed ‎statistically significant difference between baseline levels and levels at time of remission. However, platelet ‎count and serum albumin were not statistically different. The mean FC level at the time of diagnosis was ‎‎823.61±545.457μg/mg and after remission was 165.18±202.255μg/mg (P 0.000)‎‎‎‎. Conclusion: Markers (FC, ESR, serum total proteins and HB level) can be used as non-invasive markers for monitoring ‎IBD activity and severity in the primary health care centers. Fecal calprotectin correlate with endoscopic ‎disease activity. Furthermore, the initial level of FC is a predictor of early dysplasia in ulcerative colitis ‎patients‎ ‎‎.

This study was designed to determine the effect of Chromium methionine (CrMet) at different levels on growth parameters, blood constituents, immunity, and anti-oxidative properties of growing Japanese quail. A total of 150 7-day old unsexed Japanese quail chicks were randomly distributed to five dietary treatments of thirty birds to a treatment. Each treatment was replicated three times with ten birds to a replicate. Five isocaloric and isonitrogenous diets were formulated. CrMet was added to the basal diet at five different levels being 0, 200, 400, 600, and 800 mg /kg diet, respectively. CrMet supplementation improved body weight (BW) at 6 weeks of age by 2.3%. compared with those on diet 1 (control). Feed intake (FI) increased gradually by increasing CrMet levels in the diets compared with the control group and the group fed on 200 mg CrMet /kg diet. The best (P≤ 0.05) value of feed conversion ratio (FCR) was noticed in group fed 600 mg CrMet /kg as compared with other experimental groups. CrMet improved (P ≤ 0.01) the thymus, heart and testes weights, white blood cell (WBC) counts, hemoglobin (Hb), Packed cell volume (PCV%), and monocytes of growing Japanese quail. Also, Alanine aminotransferase (ALT) and total antioxidant capacity, while albumin, albumin/globulin ratio, aspartate aminotransferase (AST), total lipids, cholesterol, triglycerides, and lipid peroxide concentrations contents decreased significantly (P ≤ 0.01). In summary, inclusion of CrMet in growing quail diets may exert beneficial effects on growth parameters, blood constituents, immunity, and anti-oxidative properties.

Establishing the diagnosis of viral diseases often needs sophisticated settings, equipment, expertise, and strict laboratory methods In Sudan, as in most developing countries, viral diseases are mostly diagnosed by clinical presentation As most viral infections are self-limiting and there is no specific treatment for most of them, laboratory diagnosis has not been a focus for improvement, particularly in public sector until the current pandemic of COVID-19 During this pandemic, the vital need for well-equipped clinical virology laboratories is urged The aim of this work is to highlight the various diagnostic methods and to describe the current situation of clinical virology diagnostics in Sudan [ABSTRACT FROM AUTHOR] Copyright of Sudan Journal of Medical Sciences is the property of Knowledge E DMCC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Background: Hepatitis E virus is a zoonotic virus with a worldwide epidemic outbreak. The aim of the study was to identify relative risk factors and co-infections concerning the seropositive HEV IgG among blood donors and haemodialysis (HD) patients in the central blood bank and renal dialysis centre in Wad Medani city, Gezira State, Sudan. Materials and Methods: This was a cross-sectional study that included 600 participants, among them 180 showed strong seropositive HEV IgG. The structured questionnaire was used to collect data of the participants' demographics, disease risk factors and HEV IgG co-infections with HBV, HCV, HIV and syphilis. Results: Among the 180 strong seropositive HEV IgG respondents, 84 were blood donors and 96 were haemodialysis patients. The gender and age (18–30 years) had a significant association with the virus exposure (P = 0.000, P = 0.000). Importantly, a significant association of HEV prevalence due to the localities effect exhibited with the highest rate among South Gezira (OR = 38, CI = 14.1–107; P = 0.000). This also observed in Wad Medani, Umm Algura, East Gezira and Managil localities (P = 0.000). The effect of the animal contact on HEV distribution exerted the significant association among the respondents for blood donors and haemodialysis patients in univariate (OR = 4.09, 95% CI 1.5–10.9; P = 0.005) and multivariate (OR = 3.2, CI = 1.1–9.4; P = 0.027) analysis. Conclusion: The relative risk factors of the HEV seroprevalence were gender, age, locality and animal contact. Besides the need of a regular survey for the virus seroprevalence, primary health care physicians can play pivotal role in health education, especially in rural areas of Sudan. In addition, primary health care physicians in Sudan are expected to establish strategies and plans to eradicate and minimise the health impact of HEV.

Ultra-reliable low-latency communication (URLLC) has been considered as a major use case for the fifth generation (5G) wireless networks. Therefore, the Third Generation Partnership Project (3GPP) has targeted the support of URLLC in the new radio (NR) air interface by introducing several technologies such as short transmission time intervals (sTTIs) and puncturing scheduling. However, scheduling URLLC without impacting the quality-of-service (QoS) of enhanced mobile broadband (eMBB) traffic is a challenging task. In this paper, we optimize the resource allocation and scheduling process of URLLC puncturing eMBB transmissions by considering the QoS of eMBB and the transmission errors associated with the finite blocklength coding of the URLLC traffic. In addition, we propose a deep supervised learning approach to predict the optimized resource allocation in a computationally efficient manner to be practically used in real-time operation. The numerical results show that by adjusting the model parameters, we can increase the accuracy of the lowcomplexity predictions for an efficient scheduling scheme with superior performance as compared to other techniques.

Essential oils (EOs) and their active components are attracting a lot of attention as sustainable feed additives due to their known antimicrobial properties against a variety of microorganisms, including bacteria, protozoa, and fungi. They also have biological therapeutic, antioxidant, and flavor properties. They can be used for modifying the rumen environment and improving animal productivity. The present study was designed to investigate the effect of supplementation with 2.5 and 5 g/head/day of an essential oils blend (EOB) of clove, oregano, and juniper in equal proportions on milk production and quality, and physiological status of early lactating Holstein dairy cows for 8 weeks of treatment followed by 8 weeks of posttreatment. The results revealed an improvement in milk yield (p &le, 0.02) and feed efficiency (p &le, 0.001) with EOB at a dose of 2.5 g/head/day. The percentages of milk protein and lactose were increased (p &le, 0.03) with a high dose of EOB inclusion during the treatment period as compared with the control group. Milk fat percentage, fat-corrected milk, and energy-corrected milk were not significantly affected by EOB supplementation. The supplementation of EOB tended to decrease milk total bacterial and somatic cell counts when compared to the control group. The supplementation of EOB at both doses increased serum total protein (p &le, 0.02) and globulin (p &le, 0.05), and decreased cholesterol level (p &le, 0.001) and creatinine (p &le, 0.001) as compared to the control group. Furthermore, the results show that the low dose of EOB had more desirable effects on milk yield, milk total bacterial count, milk somatic cell count, and feed efficiency than the high dose, suggesting that lower doses may not inhibit rumen microbial populations. Moreover, the low doses of EOB could be used as sustainable natural alternatives to antibiotics in livestock diets.

This paper investigates the physical layer security of inband underlay Device-to-Device (D2D) communication, where there is no direct link between D2D users. In this respect, optimal relay selection is utilized to secure the D2D transmission. The eavesdropper uses either maximal-ratio combining or selection combining to improve the wiretapped signals. The D2D secrecy performance analysis is performed regarding the secrecy out-age probability (SOP) and the probability of non-zero secrecy capacity, and closed-form expressions are provided. To validate the correctness of our analysis, numerical and simulation results are presented. Furthermore, the asymptotic analysis of the SOP is provided, where new insights into the system parameters are revealed.

IntroductionCOVID-19 can have even more dire consequences in countries with ongoing armed conflict. Libya, the second largest African country, has been involved in a major conflict since 2011. This study analyzed the epidemiological situation of the COVID-19 pandemic in Libya, examined the impact of the armed conflict in Libya on the spread of the pandemic, and proposes strategies for dealing with the pandemic during this conflict.MethodsWe collected the available information on all COVID-19 cases in the different regions of Libya, covering the period from March 25 to May 25, 2020. The cumulative number of cases and the daily new cases are presented in a way to illustrate the patterns and trends of COVID-19 and the effect of the ongoing armed conflict was assessed regionally.ResultsA total of 698 cases of COVID-19 were reported in Libya during a period of three months. The number of cases varied from one region to another and was affected by the fighting. The largest number of cases was reported in the southern part of the country, which has been severely affected by the conflict in comparison to the eastern and western parts of the country.ConclusionThis study describes the epidemiological pattern of COVID-19 in Libya and how it has been affected by the ongoing armed conflict. This conflict seems to have hindered access to populations and thereby masked the true dimensions of the pandemic. Hence, efforts should be combined to combat these consequences.

Shortened transmission time interval (sTTI) is considered one of the most significant enhancements to evolve the current Long-Term Evolution (LTE) networks to fulfill the 5G requirement of supporting critical machine-type communications (cMTC). However, scheduling the sporadic cMTC and the data-intensive human-type communications (HTC) on different scales of transmission duration is a challenging task. In addition, the finite blocklength coding of the small-size packets of cMTC makes the process more challenging. In this paper, we address the scheduling problem of cMTC coexistent with HTC in LTE. In this regard, we formulate the processes as optimization problems that maximize the system utility while providing guarantees for the different quality-of-service (QoS) of both types of traffic. Moreover, we propose computationally-efficient algorithms that utilize the matching theory and analyze them from a practical perspective to prove that they can be used as practical schemes. The simulation results show a close-to-optimal performance for the proposed scheme and its superiority to conventional algorithms.

CCG Facility Integration proposed that the 4.16-kVAC power distribution in a data center greatly reduces the loss on cable, especially when compared to 480-VAC distribution. Also, it is suggested that the minimum stage of power conversion is obtained by powering each server rack with a 400-VDC bus that is directly step-downed from the 4.16-kVAC. An input-series-output-parallel (ISOP) structure becomes a promising topology for this power conversion. In addition to the modularity, the medium voltage (MV) is handled by efficient low-voltage devices connected in series, leading to high efficiency and high power density. The transformer in the DC/DC converter is crucial, since it is responsible for the MV insulation. Since insulation occupies a significant space in the transformer, the conventional optimization approach needs to be re-evaluated, especially in regard to switching frequency. The increase in spacing provides the opportunity to integrate the resonant inductor into the transformer. In this paper, a new optimization method for switching frequency is proposed with a better insulation structure. The design is demonstrated on a 200-kHz CLLC converter with 98.7 % efficiency and 61 W/in3 power density.

Background: Human immune deficiency virus (HIV) infection is a major global public health concern. Northern African countries carry a disproportionate burden of HIV, accounting for one of the highest prevalences in Africa. Here in, we sought to analyze the epidemiological characterization and spatial trends of HIV infection in the Northern African region.Methods: A systematic review was carried out on all the published data regarding HIV/AIDS in Northern African countries over a ten year period ( 2008-2017) following the PRISMA guidelines. We performed a comprehensive literature search using Medline PubMed, Embase, regional and international databases, and country-level reports were searched with no language restriction. The quality, quantity, and geographic coverage of the data were assessed at both the country and region levels. We used random-effects methods, spatial variables and stratified results by demographic factors. Only original data for the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.Results: A total of 721 records were identified by our data search , and only 41 that met our criteria were included in the meta-analysis during the study period. There was a considerable variability in the prevalence estimates of HIV within the countries of the region. The overall prevalence of HIV in northern African countries ranged from 0.9% (95% CI (0.8–1.27) to 3.8% (95% CI (1.17-6 .53)). The highest prevalence was associated with vulnerable groups, particularly drug abusers and sexual promiscuity. Dense HIV clustering was also reported during the study period, varying from one country to another. At least 13 HIV subtypes and recombinant forms were prevalent in the region. Subtype B was the most common variant , followed by CRF02_AG.Conclusion: This comprehensive review indicated that HIV infection in Northern African countries is an emerging threat. Effective strategies are needed both at national and regional levels to improve monitoring and controlling the transmission of HIV with a particular emphasis on geographic variability and HIV clustering.

Background: COVID-19 is a global pandemic that affectedaffects all aspects of life. Studies on understanding the geographical and epidemiological characteristics become particularly important in controlling the spread of the pandemic. Such studies are lacking in Northern African countries, particularly in Libya, which is considered being, the second largest country in Africa, with the longest coast facing Europe. The objectives of this study are to; determine the epidemiological parameters and spatiotemporal patterns of COVID-19 in this large country and outline the needed strategies to contain the spread and the consequences of the pandemic. Methods: This comprehensive study included all the confirmed cases of COVID-19 since its emergence in Libya, from early April 2020 until July 31th31. The epidemiological characteristics of COVID-19 were analyzed, and the spatial dynamic trends were explored. A region Region-based counts of weekly reported cases were used to characterize and quantify the spatial dynamics of COVID-19.Results: A total of 3695 of confirmed cases of OVID-19 were collected,; 2515 (68.1%) were males , and 1180 (31.9%) were females with a male-to-female (M:F) ratio of 2.1:1. Aged between 2 -and 78 years old. Older age patients infected with COVID-19 are at higher severity and mortality. A broad geographic variability and spatiotemporal spread variation of the COVID-19 pandemic in Libya was observed. Indicating. This indicates a more significant increase ofin COVID-19 from the middle of July, particularly in the West and Southern regions, although it was consistently observed in the Meddle and Southern regions.Conclusion: Evaluating the epidemiological data and the spatiotemporal dynamic trends of COVID-19 at early stages are particularly important in understanding the pandemic spread. These parameters are essential in designing effective prevention and control programs aimed at reducing the impact of the COVID- 19 pandemic, particularly in countries with limited resources.

The endoscopic retrograde cholangio-pancreatography (ERCP) is considered a main therapeutic intervention in the management of biliary and pancreatic disorders. In the average risk populations it is associated with adverse events. The most common adverse event is post-ERCP pancreatitis. Patients with liver cirrhosis are increasingly seen in ERCP theaters with different indications for the ERCP. Because cirrhotic patients are prone to complications it is expected that they develop more adverse events when operated with ERCP. Bleeding diathesis is the most serious because of the underlying coagulopathy and thrombocytopenia that are commonly encountered among them in particular with advanced Child class. In this mini review we discussed how different is the ERCP among cirrhotics regarding the expected benefits and the reported risks and we showed our experience in dealing with this subgroup of patients. The art of managing cirrhotic patients with ERCP is a team work and not a one man show.

Selecting a route is the first step in building a new electrical transmission line. The most common practice of selecting a route involves ranking possible route options, which is a complex process that demands many decision considerations to be taken into account. The ranking process is mainly done manually by humans using printed maps and field surveys that makes it time-consuming and prone to errors. In this paper, we propose a methodology to automate the process of ranking routes for an electrical transmission line using Geographic Information System (GIS) and Fuzzy Inference System (FIS). We evaluate the effectiveness of the methodology by comparing the FIS based results with industrial results of an actual project in Saskatoon, Canada. The preliminary results are very promising. Out of five route options, our methodology ranks the top three options correctly, and it successfully identifies the least preferred route options.

Demand Response (DR) is an important tool for Independent System Operators (ISO) for reliable operation of electricity markets, and there has been considerable interest from load-side market participants to offer their services for DR provisions. In this environment, the ISO needs to develop effective mathematical models for procurement of DR so as to maximize its benefits, such as reducing the peak demand, regulating electricity price shocks, and mitigating market power. In this paper, a new mathematical model for a Locational Marginal Price based, loss included, day-ahead, co-optimized, energy and spinning reserve market including DR provisions, is proposed. The proposed model includes a new proposition for load-side participants to submit price responsive demand (PRD) and load curtailment based DR bids simultaneously, in a unified market framework. Case studies considering DR providers participating in energy market only, in both energy and spinning reserve markets, and in spinning reserve market only, are presented, which examine the impact on system operation, market prices, and DR provider’s benefits. The proposed model is tested on the IEEE Reliability Test System to demonstrate its functionalities and the results clearly justify the merits of simultaneous consideration of PRD bids and load curtailment based DR offers in a co-optimized energy and spinning reserve market.

Recent Federal Energy Regulatory Commission (FERC) Order 841 requires that Independent System Operators (ISOs) facilitate the participation of energy storage systems (ESSs) in energy, ancillary services, and capacity markets, by including ESS bidding parameters that represent the physical and operational characteristics. However, in the existing market frameworks that allow Battery Energy Storage Systems (BESSs) to participate, the bids and offers do not explicitly represent the physical and operational characteristics such as the state of charge (SOC), discharge rate, degradation, etc. This paper proposes a novel BESS operational cost model considering degradation cost, based on depth of discharge and discharge rate. The model is developed considering Lithium-ion batteries, and the approach can be applied to other conventional electrochemical batteries, but not flow batteries. A detailed bid/offer structure based on the proposed BESS operational cost functions is formulated. Thereafter, a new framework and mathematical model for BESS participation in an LMP based, co-optimized, energy and spinning reserve market, are developed. Three case studies are presented to investigate the impact of BESS participation on system operation and market settlement. The proposed model is validated on the IEEE Reliability Test System (RTS) to demonstrate its functionalities.

Background The introduction of direct-acting antivirals (DAAs) for the treatment of hepatitis C virus (HCV) infections has revolutionized outcomes for patients with HCV. Cost-effective use of these antivirals in addition to ensuring patient adherence is of paramount importance. Objectives The goal of this article is to describe the processes by which a tertiary care, multisite institution managed the complexities involved in administering DAA treatment and managing the increased cost of therapy. Specifically, the objectives of this article are to describe the development of a multidisciplinary HCV management program and the role of pharmacists in this program, including formulary management strategies and monitoring of DAAs use in our institution, development of guidelines, electronic prescribing protocols and order sets, and specific outcomes based on a concurrent medication use evaluation. Practice description King Faisal Specialist Hospital and Research Centre is a tertiary care referral hospital. As a tertiary referral hospital, it offers primary and highly specialized inpatient and outpatient medical care. The process of selecting and developing institutional HCV management program is described. Practice innovation This article provides key details regarding how a multidisciplinary HCV program using DAAs can be implemented successfully at a tertiary care facility. Key facets of our innovation include establishing formulary guidelines, setting up eligibility criteria for patients, and establishing an HCV taskforce and multidisciplinary HCV program clinic. Evaluation Medication use evaluations were regularly conducted to monitor sustained virologic response rates, adherence to guidelines, adverse reactions, and drug interactions. Methods: Formulary guidelines, setting up an eligibility criterion for patients, and an HCV taskforce and multidisciplinary HCV program clinic were established. Results The involvement of pharmacists in a multidisciplinary HCV program in outpatient settings resulted in improved formulary decision making, reduction of costs, and improvement of adherence to institutional guidelines. Practice implications The role of a pharmacist in the management of patients with HCV with DAAs is important. Pharmacists play an integral part in medication management and overall reduction in health care expenditure. Many disease management programs can be complemented with pharmacists to improve patient care and reduce cost. Conclusion HCV treatment is challenging, and a multidisciplinary approach to treat HCV is critical. It is a rapidly evolving field; therefore, it requires dynamic formulary management and collaborative practice approaches to monitor pharmacotherapy carefully and efficiently. Clinical pharmacists play a pivotal role within the multidisciplinary team by providing support to both patients and health care providers with regard to the treatment of HCV.

Wireless Sensor Networks (WSNs) have received an important consideration in recent years regarding its broad area of applications. Time synchronization is one of the most important challenges of WSNs. This paper proposes a novel Optimal Distributed Consensus Time Synchronization (O-DCTS) for WSN. The proposed O-DCTS is based on some known distributed algorithms such as consensus with averaging and graph theory features. The algorithm, iteratively, updates the skew and the offset parameters of each sensor node's virtual clock. The skew compensation parameters and the offset compensation parameters are employed to update the virtual clock of each sensor node. The optimization of the proposed algorithm is applied on these two parameters, skew and offset, with respect to a minimization criterion. The convergence of the O-DCTS is studied using distance regular graphs.

Objective: The new coronavirus type SARS-Cov 2 (severe acute respiratory syndrome), which appeared in autumn 2019 in China, became a global pandemic in a few months. In this work, we looked for the potential anti SARS-Cov 2 of the compounds isolated from three Djiboutian medicinal plants, namely Acacia seyal, Cymbopogon commutatus, and Indigofera caerulea. Methods: We carried out a molecular docking with nine biomolecules, β-Sitosterol, Quercetin, Catechin, Lupeol, Rutin, Kaempferol, Gallic acid, Piperitone and Limonene on three target sites which are SARS-CoV-2 main protease (Mp), SARS-CoV-2 receptor-binding domain (RBD) and human furin protease. These targets are chosen because of their role in the process of penetration of the virus into human cells and its multiplication. Moreover, the predictions of pharmacokinetic parameters as well as toxicological properties have been determined using an online bioinformatics tool named SwissADME and AdmetSAR respectively. Results: The phenolic compounds have a very good affinity on these three target sites with binding energies of up to-9.098 kcal/mol for rutin on SARS-CoV-2 Mp, much better than the two reference drugs hydroxychloroquine (-5.816 kcal/mol) and remdesivir (-7.194 kcal/mol). Except for β-Sitosterol, the tested biomolecules have weak toxicity. Conclusion: These natural compounds can be used against covid 19 pending In vitro and In vivo evaluations.

This paper investigates physical layer security and data transmission in cellular networks with inband underlay Device-to-Device (D2D) communication, where there is no direct links between D2D users. We propose the use of full-duplex (FD) transmission and dual antenna selection at the relay node. Thanks to the FD transmission, the relay node can simultaneously act as a jammer to enhance the cellular network secrecy performance, while improving the D2D communication data transmission. This describes a practical attractive scheme, where spectrum sharing is beneficial for both the D2D and cellular networks in terms of throughput enhancement and security provisioning, respectively. We analyze the secrecy performance of the cellular network and derive closed-form expressions for the secrecy outage probability (SOP) and the probability of non-zero secrecy capacity. We also derive a closed-form expression of the D2D outage probability. Furthermore, asymptotic analysis for SOP is performed. Simulation and numerical results are provided to verify the efficiency of the proposed scheme and to validate the accuracy of the derived expressions.

Background The aim of the present study was to assess whether there is an association between ethnicity and the high prevalence of diabetes complications in Sudan. Methods This was cross-sectional hospital-based study with 316 individuals with diabetes conducted in Khartoum state, Sudan. A questionnaire was used to collect demographic information. In addition to measurements of blood pressure, lipid profile and HbA1c, weight and height measurement were also performed for calculation of body mass index. Results The study included individuals recruited from 62 tribes across Sudan. The effect of ethnicity on diabetic septic foot (DSF) was not statistically significant across different tribes (X-squared = 2.6098, df = 4, p-value = 0.6251). The effect of ethnicity on Albuminuria was also not statistically significant across different tribes recruited for this study (X-squared = 4.3787, df = 4, p-value = 0.3572). The Northern group carried a significantly higher unadjusted risk for development of retinopathy (OR = 1.8471, p-value = 0.04603). The Southern group was significantly different from the others regarding the effect of ethnicity on neuropathy, compared to the ‘West' group (OR = 0.1905, p-value = 0.0345). The unadjusted effect for the Southern group was also significant (OR = 0.2933, p-value = 0.0320). Conclusion There was no role of ethnicity in term of DSF and albuminuria complications. However, retinopathy likely to be seen in tribes originally from north of Sudan, while neuropathy is more likely to be found in tribes originally from the south of Sudan. Further focus genetic population testing is needed.

Mobile crowd-sensing (MCS) is a new sensing paradigm that takes advantage of the extensive use of mobile phones that collect data efficiently and enable several significant applications. MCS paves the way to explore new monitoring applications in different fields such as social networks, lifestyle, healthcare, green applications, and intelligent transportation systems. Hence, MCS applications make use of sensing and wireless communication capabilities provided by billions of smart mobile devices, e.g., Android and iOS-based mobile devices. The aim of this paper is to identify and explore the new paradigm of MCS that is using smartphone for capturing and sharing the sensed data between many nodes. We discuss the main components of the infrastructure required to support the proposed framework. The existing and potential applications leveraging MCS are laid out. Furthermore, this paper discusses the current challenges facing the collection methodologies of the participants’ data in task management. The recent issues in the MCS findings are reviewed as well as the opportunities and challenges in sensing methods are analyzed. Finally, open research issues and future challenges facing MCS are highlighted.

Background: Nonadherence to medication is widespread in epilepsy and other chronic diseases. Studies reporting adherence to antiepileptic medications are very limited in African countries. Adherence reports from low income African countries are few in contrast to multiple studies from high-income countries. Therefore, the aim of this study is to measure the level of adherence to antiepileptic medication in Sudanese population. Methods: A descriptive cross-sectional study of 96 individuals with epilepsy recruited from neurology outpatient clinics in three tertiary centers in Sudan. Data were collected by using a structured questionnaire containing Morisky Medication Adherence Scale-4 (MMAS-4) and Belief about Medication Questionnaire and analyzed by statistical package of social sciences. Results: About 35% of patients were estimated to be nonadherent. Most of the patients (93%) acknowledged their need for antiepileptic drugs. However, 35% had high concern score. Adherence is affected by attitude toward antiepileptic drugs (AEDs) and presence of side effects to AEDs. The relation between side effects and adherence was significant (P value 0.000). Furthermore, there was a statistically insignificant relation between the number of drugs used and adherence (P value 0.002). There was a significant relation between adherence, necessity mean score, concern mean score, and necessity concern differential P value 0.000 for all. Conclusion: Nonadherence to antiepileptic medication was reported in almost in one third of individuals in this cohort. There were statistically significant associations between nonadherence and both side effects and number of medications used in the treatment of epilepsy. Therefore, family physician should always check compliance with antiepileptic medication. Patient's education about adherence to medication through family physician may in part decrease the recurrence of epileptic seizures. Further research is needed to explore ways to increase adherence with AEDs in a low resource country like Sudan.

Background: Vitamin D deficiency is a worldwide concern. The aim of the current study was to determine the vitamin D level and its contributing factors in Sudanese women. Methods: In this cross-sectional study, 251 Sudanese women attending Family Health Centers in Khartoum, Sudan were interviewed. Following the exclusion of confounding factors, samples from 190 women were analzsed. Serum 25 hydroxyvitamin D “25(OH) D” was quantified using competitive electrochemiluminescence immunoassay. Results: Participants’ age ranged from 18 to 85 years with a mean age (±SD) of 40.2 (±14.06) years. The mean (±SD) vitamin D level was 13.4 (±6.72) ng/ml, ranged 3.00–36.5 ng/ml and the median was 12.7 ng/mL. In total, 157 out of 190 (82.6%) had vitamin D serum levels below 20 ng/ml (deficient); of whom, 52 (27.4%) were in the age group 21–30 years (P value = 0.228). The correlation between vitamin D level and residence outside Khartoum, sun-exposed face and hands, and face and limbs in comparison with being completely covered were found to be statistically significant (p values 0.008, 0.023, and 0.036). Conclusion: This study displayed a high percentage (82.6%.) of vitamin D deficiency among women in Sudan, and this in part may indicate that sunshine alone cannot guarantee vitamin D sufficiency in the tropics. Family physicians in tropical countries should screen those with clinical presentations related to vitamin D deficiency.

Background Fasting during Ramadan for some individuals with diabetes may lead to complications. Pharmacists may assist in dose adjustment and compliance with medication during Ramadan. Therefore, the aim of this study was to assess the knowledge, attitude and practice of Sudanese community pharmacists in the management of diabetes during Ramadan. Method A cross-sectional study from April to June 2017, included 330 pharmacies in Khartoum state. The sampling technique was done by two methods using stratified and systematic methods for seven localities of Khartoum State. The community pharmacists were assessed in their knowledge about Medication regimen adjustment (MRA), diabetes risk stratification and the condition in which the fasting diabetic patient have to stop their fast. Results The total response rate was 311(94.2%), and the females were 203(65.3%). Pharmacists mean age was 27.6 (SD = 5.9), ranged between 21-62 years. Importantly, more than 75% of the Pharmacists have sufficient knowledge of both identifying high-risk individuals and whether they need to break their fasting. The practice questions answered correctly by more than 80% of pharmacists in relation to monitor blood glucose level, undergo meal planning to avoid hypoglycemia and dehydration during prolong fasting hours and to undergo meal choices to avoid postprandial hyperglycemia. Importantly, 56.9% community pharmacists advised individuals with diabetes about physical activity. The barriers that hindering the proper counseling was attributed to the Lack of knowledge (71.4%). MRA was reported as highly important by (56.6%) and extremely important by (39.2%). The confidence of knowledge about MRA was reported by 52.1%. Conclusion This study showed that pharmacists had sufficient knowledge, positive attitude and good practice about diabetes management during Ramadan.

For distribution network operators to make effective decisions about real-time applications, they should have complete knowledge of all system variables. However, measuring all variables is infeasible due to the large number of system buses and the consequently high cost of measurement devices. Network operators are thus in serious need of methods that can estimate system voltages and currents with only a few measuring devices. This paper presents a novel voltage, current, and power loss estimation technique for distribution networks characterized by a high level of distributed generation (DG) penetration. The proposed method is based on online measurements from smart meters (SMs) placed at a few selected locations in addition to the measurements from DGs production meters; the estimation is derived without any pseudo measurements. The ingenuity of the proposed technique is that the SM locations are dependent on the network topology only, which means that their locations remain unchanged regardless of penetration levels and/or DG injection points. The proposed technique also includes consideration of variations in X/R ratios and laterals. The developed algorithm was implemented and tested on three radial distribution feeders to show the capability of the proposed technique for estimation for balanced as well as unbalanced distribution networks. The results of a comparison with the actual load flow demonstrate the accuracy and effectiveness of the new technique.

Consequences of varicella zoster infection reflect a wide range of minor to serious complications involving the central nervous system. This is a case series with challenging presentations, imaging features and favorable outcome. For example, the cases presented with clinical features that resemble Brown Sequard Syndrome, transverse myelitis manner and multiple sclerosis and cognitive decline. We recommend adequate history taking, clinical examination and use of available investigation. Early treatment is likely to prevent any disabling neurological damage.

Aim: This review provides a comprehensive overview of more than 100 of the most cited studies in general medical journals and evaluates whether citations predict the quality of a scientific article. Background: The number of citations is commonly used as a measure of the quality and impact of a scientific article. However, it is often criticised that the number of citations is in fact a poor indicator of the true quality, as it can be influenced by different factors such as current trends. Methods: This review was conducted in line with the PRISMA guidelines. The Journal Citation Report (JCR) within Incites allowed the evaluation and comparison of articles, published in general medical journals, using far-reaching citation data drawn from scholarly and technical journals and conference proceedings. All steps of the review were performed in duplicate and conflicts were resolved through consensus. Results: The 100 most cited articles published from 1963 until the end of 2018 were identified. The number of citations ranged from 4012 to 31853. Most of the articles were published in the 2000’s, followed by the 1990’s, 1980’s, 1970’s and 1960’s, respectively. All of the articles were published in five journals. There were 50 studies at level II, 28 at level V, 10 at level IV, 7 at level III, and 5 at Level I. Conclusion: This systematic review provides an overview of the most cited articles, published in general medical journals. The number of citations provides an indication of the quality of evidence. However, researchers and clinicians should use standardized assessment tools rather than solely rely on the number of citations in order to judge the quality of published articles.

Introduction North Africa is known to be endemic for hepatitis D virus. However, data one the prevalence of this virus in Libya are scanty. This study aimed to determine the prevalence of hepatitis D virus infection in Libya and analyze the demographic factors associated with the infection, and also to assess the variations across the regions and districts. Methods A total of 1873 samples collected from all over the country were tested for antibodies against hepatitis B surface antigen and the results were correlated with demographic and geographic variables. Results The overall prevalence of hepatitis D virus infection was 1.7%. The prevalence rate was significantly high among those aged over 40 years (P < 0.001) and it was associated with intravenous drug use and coinfection with human immunodeficiency virus and/or hepatitis C virus infection (P < 0.001). The prevalence rates varied with geographic location and differed markedly within the regions the country. The highest rate reported was in the central region of Libya, followed by the western and eastern regions. Conclusion Hepatitis D virus infection rate in Libya is considered to be low but is of some concern in some districts. This has been propagated by population displacement and African immigrants, indicating that a continuous epidemiological surveillance program should be implemented.

Background: The gallstones are common health problem across the world with huge financial burden on health authorities. Obesity and insulin resistance are associated with risk of gallstones disease (GSD). The aim of this study was to assess the prevalence of metabolic syndrome (MetS) and diabetes and associated risk factors in Sudanese patients with gallstones. Methods: A prospective cross-sectional study, enrolled patients with gallstones attending Ibn Sina Specialized Teaching Hospital for gastrointestinal and hepatobiliary diseases. A structured questionnaire was applied, anthropometric measures were taken, and blood tested for HbA1c, fasting glucose and lipid profile. Data was analysed using SPSS version 23. Results: A total number of 151 participants were recruited in the study, 71 of them were ultrasound confirmed GSD patients, and the other 80 were controls without GSD over a period of six months. The prevalence of the MetS and diabetes was 30% and 23.9% respectively. Borderline diabetes was 16.9% and overweight and obesity constituted more than half of the sample 59.6%. Using Chi-Square test, a statistically significant association was found between MetS and HDL, TG, LDL level, waist circumference and blood pressure (BP). Absolute predictors and the risk factors for gallstone disease were waist circumference, age, HbA1c and LDL. Conclusions: The prevalence of MetS and diabetes among gallstone patients was 30% and 23.9% respectively. Absolute predictors and the risk factors for gallstone disease were waist circumference, age, HbA1c and LDL.

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: Up to the point of writing this review, there is no scientific evidence of any effective medical therapy for coronavirus disease 2019 (COVID-19). In this review, we attempted to discuss the current summary of evidence of some medication, currently in trial for the treatment of COVID-19. Material and Methods: We have done an electronic literature search using the following database: PubMed, Medline, Scopus and Google scholar. These databases were searched using the keywords COVID-19 and pharmacological therapy. Results: At present, there are no well randomized controlled studies which can give evidence for most of the therapy used for COVID-19. Several medications are in trials for COVID-19, among them: 1/ chloroquine and hydroxychloroquine; 2/anti-virals oseltamivir, remdesivir, lopinavir/ritonavir and other protease inhibitors; 3/antibiotics macrolide (Azithromycin); 4/cytokine therapy interferon; 5/ humanized monoclonal antibody tocilizumab; 6/adjunct therapies vitamins C, D, and herbal medicine; 7/ COVID-19 convalescent plasma; 8/systemic steroids; 9/expected COVID-19 vaccine. We have also included some of the herbal medicines that are commonly and widely used in the Middle East, Asia as well in Sudan, (black seeds, honey and Acacia Nilotica). It is worth mentioning that these herbal medicines have shown benefits in treating other diseases, but the evidence of their benefit in COVID-19 still needs to be established. Conclusion: Currently there is no pharmacological therapy for the COVID-19. More research and randomized clinical trials are needed to find effective therapy or vaccine against COVID-19. Keywords: COVID-19, Pharmacotherapy, herbal medicine, Sudan