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Background: Patients with diabetic foot ulcers are at a high risk of having both minor or major lower extremity amputations.Aim: To identify the extent of risk factors for major and minor amputations in patients with diabetic foot ulcers.Materials and Methods: This prospective study was conducted from 2003 to 2005. Using the guidelines for wound classification developed by the International Consensus of the Diabetic Foot, patients were assessed for ischemia, neuropathy, linear measurement of wound diameters, depth of wound, and infection. In addition, end stage renal failure was added as a criterion to assess the association of all these criteria with both toe and lower extremity amputation.Results: 2,321 patients were studied and their mean age was 55 +/- 12 years. Most (83.5%) of the patients presented with foot ulcers (n = 1394). Plantar ulcers were the most common (42.6%) followed by ulcers of the big toe (39%). Some (28.5%) of the patients had different types of amputations: 10% had major lower extreme amputation (MLEA) with 8.7% amputations being below the knee and minor (toe) amputations accounting for 18.5%. The most commonly amputated (9.9%) toe was the first toe.Conclusion: The guidelines for wound classification proposed by the International Consensus of the Diabetic Foot are reliable predictive factors and can determine the outcome of diabetic foot management. Significant factors associated with MLEA were ischemia, neuropathy, and end-stage renal disease and those associated with toe amputation were neuropathy, depth of wound, and grade of infection. [ABSTRACT FROM AUTHOR]

The steady laminar flow and heat transfer of an incompressible, electrically conducting, non-Newtonian Bingham fluid in an eccentric annulus are studied in the presence of an external uniform magnetic field. The inner cylinder is subject to a constant heat flux while the outer cylinder is adiabatic and, the viscous and Joule dissipations are taken into consideration. The governing momentum and energy equations are solved numerically using the finite difference approximations. The velocity, the temperature, the volumetric flow rate and the average Nusselt number are computed for various values of the physical parameters. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer is the most common cancer and the highest cause of cancer mortality in women worldwide), the second most common cause of cancer death in women, and the main cause of death in women ages 40-59. It is increasingly reported in young premenopausal women in Egypt. About 25% of all breast cancers are diagnosed in premenopausal women and about 15% occur in women under 45 years of age. Adjuvant chemotherapy improves survival; however, one of the most frequent therapy-related adverse events observed, is the consequence of ovarian failure in premenopausal patients. Objective: This study aim ,was to find the incidence of chemotherapy-induced ovarian failure (CIOF) and reversible amenorrhea in premenopausal breast cancer patients, after adjuvant chemotherapy, at National Cancer Institute (NCI), Cairo University, and to review the clinical consequences of ovarian failure specially amenorrhea and postmenopausal symptoms. Patients and Methods: This retrospective cross-sectional study, included all premenopausal breast cancer patients with early breast cancer with at least a minimum follow up of one year after last cycle of adjuvant chemotherapy, within a 6 month period, 100 female patients referred to Medical Oncology Clinic in National Cancer Institute from September, 2013 till Marche, 2014. Age at diagnosis from 20 till 54 years old. Evaluation of risk factors included: age, type, dose and schedule of chemotherapy, hormonal treatment, menarche, oral contraceptive pills intake, a clinical history of the patients' menstrual cycle was taken, along the course of the patients' breast cancer treatment. Timing of chemotherapy induced ovarian failure, duration of amenorrhea. Reversibility of amenorrhea, influence of additional hormonal treatment on the frequency menstruation. The primary endpoints of this study are to determine the incidence of CIOF and the reversible amenorrhea and the clinicopathological features of patients who developed amenorrhea. Results: The study included 100 Egyptian female patients. The mean age of the subjects was 45 years. Of the patients, 56 were amenorrheic at completion of study and 44 regained menstruations, on average after 8 (range 2-24) months post-chemotherapy. Risk factors associated with chemotherapy-induced ovarian failure (CIOF) were analyzed, only the patient age at diagnosis, was found to be statistically significantly associated with reversible chemotherapy-induced amenorrhea. Conclusion: This retrospective study found a high incidence of CIOF, with a relatively low rate of reversible amenorrhea. Analysis of patients clinicopathologic factors showed that, only the patient age has been shown to be an independent factor, statistically significantly associated with ovarian failure after chemotherapy. Advances in fertility preservation options are now available to prevent such a problem using biological interventions to reduce the impact of chemotherapy on ovarian reserves, e.g. with GnRH agonists, or removal and preservation of ovarian tissue/mature oocytes/embryos for fertility treatment after breast cancer treatment. [ABSTRACT FROM AUTHOR]

Introduction Encephalitis, meningitis, and meningoencephalitis present significant challenges in clinical management owing to their diverse etiologies and potential complications. A high suspicion index is critical for guiding treatment strategies and improving patient outcomes. Understanding the demographic characteristics and frequency of causes of these conditions is essential to deliver optimized care. Objective This study aimed to investigate epidemiological causes and relative outcomes, including mortality, based on cultures, laboratory investigations, and demographic factors among patients with encephalitis, meningitis, and meningoencephalitis in a Saudi Arabian tertiary care center. Methods A retrospective cross-sectional study was conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Data were collected from patients admitted between April 2016 and December 2022 who met the specified inclusion criteria. Results Among 233 patients, meningitis was the most prevalent diagnosis (65.77%), with bacterial agents being the predominant causative agents (79.74%). Higher mortality was significant with pediatrics <5 years and adults >60 years. Conclusion This study provides valuable insights into the epidemiology and clinical outcomes of central neurological infections based on a Saudi Arabian cohort. These findings underscore the importance of an accurate diagnosis and tailored management strategies. Further studies are warranted to enhance our understanding and to inform more predictable characteristics targeted in optimizing healthcare delivery for patients with such conditions., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King Abdullah International Medical Research Center (KAIMRC) issued approval IRB/1425/23. Institutional Review Board (IRB) and ethical approval was obtained from King Abdullah International Medical Research Center (KAIMRC) study number SP23J-027-03. Reference number: JED-23-427780-39267. No identifiers were collected, and all patients' data were securely stored in a password-protected device, which was saved within the hospital premises and accessible exclusively to the research team. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Attar et al.)

Introduction In December 2019, COVID-19 originated in Wuhan, China, triggering a global pandemic. However, the Saudi Arabian Ministry of Education ensured the safe continuation of teaching and learning activities. Amid the pandemic, health sciences students were exposed to diverse learning opportunities. Methods This study seeks to explore their experiences with online teaching. Conducted as a descriptive cross-sectional study, it involved 397 health sciences students from three universities in the Makkah province who had encountered both traditional and virtual teaching methods. Results Most participants were female (71.1%), predominantly from Jeddah city (76.5%). The highest agreement scores were observed for student comprehension during online sessions (61.1%). A significant proportion (74.4%) found paying attention during online lectures easier than traditional ones. Blackboard emerged as the preferred educational platform for online teaching. Notably, there were no significant variations in students' perceptions of online teaching based on location, gender, or specialisation. Approximately 54.7% of students preferred watching their instructors through a webcam during online lectures. Conclusion Medical educators can leverage these findings to develop standardised teaching protocols and enhance the effectiveness of online education systems. The study underscores the importance of instructors using webcams during online teaching sessions, as it allows students to visually connect with their instructors, potentially improving the learning experience., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Alharbi et al.)

Background: Pulmonary function test (PFT) is used as a tool for pre-transplant risk assessment and as a predictor of post-transplant outcomes. As there are currently few studies that discuss the role of PFT in bone marrow transplantation (BMT) patients in Saudi settings, and as the number of transplant patients with benign and malignant conditions continues to increase, this study was conducted with the aim of assessing the local practice., Methods: This retrospective cohort study included all adult patients who underwent BMT at Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, between 2014 and 2020. The association between established patient-related risk factors and the incidence of pulmonary complications among autologous and allogeneic groups was assessed., Results: A total of 186 patients were included (autologous = 143; allogenic = 43), of which 115 (61.8%) were male. At the pre-BMT phase, about 30% of the patients had comorbidities and 51% had received two rounds of salvage chemotherapy, while 16.1% had received radiation therapy. In the autologous group, the only PFT parameter that was a significant predictor of post-BMT pulmonary complications was forced vital capacity <80% ( P = 0.012), while in the allogenic group, no parameter was significantly associated with pulmonary complications. The patient-related factors that were associated with respiratory distress in the autologous group were lung involvement ( P = 0.03) and pre-transplant radiation ( P = 0.044)., Conclusion: The findings of this study indicated that forced vital capacity <80% was a significant factor in predicting non-infectious complications in the autologous group. Furthermore, lung involvement and pre-transplant radiation were the patient-related factors associated with pulmonary complications., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Saudi Journal of Medicine & Medical Sciences.)

The current study proposes a new strategy for using small hydroelectric turbines in downstream river branches with the least amount of construction and the lowest cost by comparing two different methods of installing the turbines, the first by installing the turbines at the river's bottom and the second by installing the turbines on floating boats. The methodology of this article is based on predicting the distribution of velocities through the watercourse using experimental data collected at various points in the river's depth, and then predicting the resulting electrical power for different sizes of turbines, as well as estimating the number of turbines for each row and the number of rows along the river. Therefore, Investigate the proposed systems. The proposed small hydropower system's economic viability and environmental impact are investigated in this article. According to the nature of the waterway, the best diameter of a turbine that can be used is 1.5 m based on water velocities and river depths. The proposed power plant generated 25.8 kW per single turbine row, with an estimated cost of produced power (0.035 USD/kWh) of approximately 20 turbines installed per row. Compared to other renewable energy sources, the proposed hydropower system is cost-effective and environmentally friendly, as generating electricity with the proposed small hydropower plant could reduce annual carbon dioxide emissions by 368 tones of CO 2 per single turbine row., (© 2023. Springer Nature Limited.)

Introduction: Sexual functionality is considered a vital component of human life and quality of life. Issues with sexual functionality can be a source of distress, lower self-esteem, and lower quality of life. Early detection of medical comorbidities can significantly lower the effect on sexual function. In Saudi Arabia, studies investigating the association between medical comorbidities and male sexual dysfunction (MSD) are limited. Therefore, our goal was to fill this knowledge gap., Aim: This study aimed to analyze and elaborate on all cases of MSD at a tertiary hospital, in Jeddah, Saudi Arabia from 2016 to 2021., Method: This is a cross-sectional retrospective study. The medical records of 321 patients diagnosed with MSD from 2016 to 2021 were reviewed retrospectively. The age, sex, type of sexual dysfunction, comorbidities, and lipids profile were some of the factors obtained from the patient's computerized medical records., Results: The study population included 321 men with MSD and a mean age of approximately 53 years (SD=11.5). Among the sexual dysfunction pattern, only erectile dysfunction (ED) was found in 279 (86.9%) patients. ED duration lasted one to five years in 169 (52.8%) patients. Most of the patients (196, 61.1%) had mild ED severity. Medical causes were seen in 278 (80.4%) patients. The most frequent comorbidities were diabetes mellitus (DM) in 179 (55.8%) patients, hypertension (HTN) in 155 (48.2%) patients, and dyslipidemia in 113 (35.2%) patients. Smoking was not a risk factor for ED. The risk of having a severe form of ED was associated with idiopathic causes, HTN, DM, and ischemic heart disease (IHD). The risk of having a long duration of ED was related to idiopathic causes of ED and high serum creatinine levels., Conclusion:  In conclusion, patients diagnosed with DM, HTN, and IHD are at greater risk to experience a severe form of ED. It is crucial to keep erection function in mind for patients with DM, HTN, and IHD as this is associated with severe ED., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Bogari et al.)

Introduction: We aimed to assess the impact of discharge instruction (DCI) readability on 30-day postoperative contact with the healthcare system., Materials and Methods: Utilizing a multidisciplinary team, DCI were modified for patients undergoing cystoscopy, retrograde pyelogram, ureteroscopy, laser lithotripsy, and stent placement (CRULLS) from a 13th grade to a 7th grade reading level. We retrospectively reviewed 100 patients including 50 consecutive patients with original DCI (oDCI) and 50 consecutive patients with improved readability DCI (irDCI). Clinical and demographic data collected including healthcare system contact (communications [phone or electronic message], emergency department [ED], and unplanned clinic visits) within 30 days of surgery. Uni/multivariate logistic regression analyses used to identify factors, including DCI-type, associated with increased healthcare system contact. Findings reported as odds ratios with 95% confidence intervals and p values (< 0.05 significant)., Results: There were 105 contacts to the healthcare system within 30 days of surgery: 78 communications, 14 ED visits and 13 clinic visits. There were no significant differences between cohorts in the proportion of patients with communications (p = 0.16), ED visits (p =1.0) or clinic visits (p = 0.37). On multivariable analysis, older age and psychiatric diagnosis were associated with significantly increased odds of overall healthcare contact (p = 0.03 and p = 0.04) and communications (p = 0.02 and p = 0.03). Prior psychiatric diagnosis was also associated with significantly increased odds of unplanned clinic visits (p = 0.003). Overall, irDCI were not significantly associated with the endpoints of interest., Conclusions: Increasing age and prior psychiatric diagnosis, but not irDCI, were significantly associated with an increased rate of healthcare system contact following CRULLS.

Prostate cancer and bladder cancer are two of the most common urologic cancers. Cancer risk stratification and prediction of prognosis have always been challenging. Following recent advances in genomic and proteomic technologies, several genomic biomarkers have been developed and proposed as a noninvasive and nonexpansive approach that can supplement our current data to improve prediction and accuracy. Several biomarkers have shown efficacy in patient risk stratification and in predicting prognosis. Here we provide a mini-review of current RNA biomarkers approved by the US Food and Drug Administration, including the Decipher, Oncotype DX Prostate, and Prolaris tests. We also provide a summary of their approved clinical utility in prostate cancer and bladder cancer management. PATIENT SUMMARY: A number of tests are available for measuring expression levels of genes related to prostate or bladder cancer. We review the usefulness of these tests in stratifying risk for patients and predicting their prognosis., (Copyright © 2022 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Introduction: Radium-223 (Ra-223) has been recommended for bone-dominant metastatic castration-resistant prostate cancer (mCRPC). Second-generation hormone therapy in combination with Ra-223 in mCRPC has been utilized, yet its benefit has not been well elucidated. We investigated the potential survival benefit of concomitant enzalutamide with Ra-223 in the third-line setting and predictors of improved overall survival (OS)., Patients and Methods: We retrospectively identified 51 patients with bone-dominant mCRPC that were treated with Ra-223 in the postchemotherapy and post-hormone therapy setting, either alone (group A; n = 32) or with concomitant enzalutamide (group B; n = 19). The primary endpoint was to study the OS difference between groups A and B. The secondary endpoint was to identify predictors of improved OS with Ra-223 in the third-line setting., Results: Mean age was 70.9 years, median baseline prostatic-specific antigen (PSA) was 23.1 ng/mL, alkaline phosphatase was 91 IU/L, and hemoglobin was 12.5 g/dL. There was no difference in median OS between groups A and B, at 20.4 versus 17.5 months, respectively (P = .5186). In univariate and multivariate analyses, only pre-Ra-223 PSA < 30 ng/mL and Eastern Cooperative Oncology Group performance status < 2 were associated with improved OS., Conclusion: In our study cohort, concomitant use of enzalutamide with Ra-223 in the mCRPC setting was not associated with improved OS. Only pretreatment PSA < 30 ng/mL and pretreatment Eastern Cooperative Oncology Group performance status < 2 were associated with improved OS. Further prospective studies are warranted., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: Congenital hypothyroidism (CH) is a common cause of preventable severe neurocognitive impairment in children. Previously conducted studies describing the natural history of CH in Saudi Arabia were either of shorter duration or a limited number of patients. In this study, we aim to assess our experience in the clinical course and therapeutic outcome of CH in two large tertiary centers in Saudi Arabia., Methods: This is a retrospective chart review of patients <18 years of age diagnosed with CH at King Abdulaziz Medical City in Jeddah and Riyadh, Saudi Arabia, between 2000 and 2018. Data were collected from the patients' medical records, including epidemiological, clinical, laboratory, and radiological features as well as a long-term outcome of CH. Statistical analysis was carried out using the JMP statistical software. This study was approved by the Institutional Review Board (IRB) at King Abdullah International Medical Research Center (KAIMRC)., Results: Out of the 71 cases, 53.5% were female, and 80.3% of these cases were diagnosed in the 1 st week of life. The estimated incidence of CH is 1:2470 in the two study centers. Ectopic thyroid (43%, n = 25/58), dyshormonogenesis (34.5%, n = 20/58), and thyroid agenesis and hypoplasia (22.4%, n = 13/58). Learning difficulty was significantly associated with delayed treatment onset ( P = 0.044) and lower compliance with treatment ( P = 0.001)., Conclusion: In our study, the incidence of dyshormonogenesis in CH is higher than international rates (34.5% vs. 20%), possibly because of consanguinity. Effective neonatal screening program facilitates early diagnosis that leads to prompt management of CH and avoidance of long-term outcome of neurocognitive impairment., (Copyright: © International Journal of Health Sciences.)

Background: Dengue fever (DF) is an arthropod-borne disease caused by dengue virus (DENV). DENV is a member of the genus Flavivirus in the family Flaviviridae. Recently, DENV has been reported as an important emerging infectious viral pathogen in Sudan. Multiple outbreaks and sporadic cases of DF have been frequently reported in the eastern region of Sudan. The present study was conducted to confirm DENV outbreak in Kassala State, eastern Sudan, 2019, and to provide some information on the molecular characterization of the DENV isolate associated with the disease outbreak., Methods: A hundred serum samples were collected during the outbreak from residents of Kassala State, Sudan, 2019. ELISA was used to detect DENV non structural protein NS1 (DENV-NS1) in acute phase sera sampled during the disease outbreak. RT-PCR assays were used to amplify a fragment of the capsid/pre-membrane region (CprM) of the viral polyprotein gene. The PCR products of the amplified CprM region of the viral polyprotein gene were purified and partial sequences were generated and used to confirm the specificity of DENV sequences and to identify the virus serotype. Phylogenetic tree was constructed to determine the genotype of DENV associated with the outbreak., Results: Using DENV-NS1 ELISA assay, DENV infection was confirmed in 23% sampled sera. The detection of DENV RNA was made possible using group-specific RT-PCR assay. The virus was serotyped as DENV serotype 3 (DENV-3) using DENV serotype-specific RT-PCR assay. Phylogenetic analysis of the partial CprM sequences of the viral polyprotein gene indicates that the virus belonged to genotype III of DENV-3., Conclusion: The scientific data presented in this investigation confirmed that genotype III of DENV-3 was associated with the disease outbreak in eastern Sudan, 2019. The study represents the first report on molecular characterization of DENV-3 in Sudan.

Background: Acute arboviral infections are distributed worldwide including Sudan, and dengue fever (DENV) is not an exception. The virus activity has recently been frequently reported in Kassala State, eastern Sudan. However, an appropriate epidemiological study would be necessary to provide accurate and precise estimates of the magnitude of recent DENV transmission in this area of endemicity., Methods: In the present investigation, a cross sectional study was conducted to advance beyond the current knowledge of the epidemiology of the disease in Kassala State. The prevalence of the disease was estimated and associated risk factors were determined. Sampled sera were collected and screened for recent dengue transmissionas as determined by DENV-IgM enzyme-linked immunosorbent assay (ELISA). The collection of data for risk assessment was supported by a well designed structured questionnaire., Results: The prevalence of recent DENV infection was estimated to be (11.42%). Potential risk factors to DENV seropsitivity include, age (OR = 3.24, CI = 1.81-5.77,p-value = 0.001); low income (OR = 3.75, CI = 1.57-8.93, p-value = 0.027); mosquito control (OR = 4.18, CI = 2.33-7.51, p-value = 0.004); and localities., Conclusion: The present study showed a high rate of circulating DENV IgM antibodies among the participants of the study (11.42%), suggesting recent transmission of DENV in Kassala State, eastern Sudan. The frequent occurrence of DENV infections necessitates the need for improved surveillance programs and prevention measures to combat this important arboviral disease in Sudan.

Objectives: To assess the long-term effect of growth hormone (GH) therapy in a large cohort of short children with different etiologies., Patients and Methods: We evaluated retrospectively the anthropometric data of 252 short children [height SDS <-2: 154 children with growth hormone deficiency (GHD), 63 with idiopathic short stature (ISS), 26 with SGA, and 9 with Turner syndrome (TS)] who were treated, in our center, with GH between 1-2007 and 1-2018. Before and during recombinamt growth-hormone (recGH) treatment, auxological parameters including height (Ht), weight (Wt), Ht - Z score (HtSDS), body mass index (BMI) and BMISDS were recorded every 6 months; bone age (BA) was assessed every 12 months., Results: At the end of first year of rhGH therapy and after an average of 3 years treatment all groups of short children had significant increase in HtSDS, which was higher in GHD compared to other groups. Children with GHD, SGA, ISS and TS increased their HtSDS by an average of 2.2, 1.46, 0.6 and 0.99 SD, respectively at the end of follow up period (for all groups, p: <0.001). The bone age/chronological age (BA/CA) ratio did not differ significantly among ISS, GHD and SGA groups after GH therapy. The HtSDS gain was higher in children with GHD compared to other ISS, SGA and TS groups (p:< 0.01; p: 0.015 and p: 0.029, respectively).  HtSDS improvement occurred during the first 3 years of rhGH therapy. The BMISDS increased significantly in children with GHD, after 3 years of rhGH therapy (p: < 0.001). After rhGH treatment, the BMISDS decreased significantly in children with ISS and SGA (p: < 0.01 and < 0.001, respectively) but did not change in children with TS (p: 0.199)., Conclusions: Children with GHD, SGA, ISS and TS exhibited significant increases in HtSDS when treated with rhGH for 3 years. The HtSDS gain was higher in children with GHD compared to other groups.

Objectives: Medical knowledge is constantly changing; this puts pressure on educators to adapt instructional strategies to their students' learning styles (LSs). Therefore, identifying the LSs of medical students could help teachers to develop teaching strategies to achieve better outcomes. The purpose of this study was to determine the LSs of health science university students, and to assess the relationship between LSs and student satisfaction with educational activities., Methods: This cross-sectional descriptive study was conducted in the Colleges of Medicine and Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) Jeddah. We used Kolb's LS and a modified Student Satisfaction Survey from Mott Community College, Michigan. All participants received self-administered questionnaires; LS and demographic data were used as predictor variables. Students' satisfaction levels were considered the outcome variable., Results: A total of 359 students were recruited (mean age 19.0 ± 1.4 years; 53.5% males). The most popular LS was Accommodator (29.2%), followed by Assimilator (27.9%) and Diverger (25.6%), while the Converger style (17.3%) was the least preferred LS. The satisfaction scores of the students showed that they were generally satisfied with a mean score of 64.4%. Males were found to have higher satisfaction across all variables than females ( p  = 0.002)., Conclusions: This study could not find a predominant LS or satisfaction difference across LSs among health science students. Thus, the current educational programmes in KSAU-HS meet students' LSs and satisfaction. Educators need to broaden their strategies for instruction, so as to build an effective learning environment., (© 2019 The Authors.)

Background: Dengue fever, caused by dengue virus (DENV), has become one of the most important mosquito-borne viral diseases with a steady rise in global incidence, including the Sudan. Sporadic cases and frequent acute febrile illness outbreaks, compatible with Dengue fever, have been reported in El-Gadarif State, Sudan. However, diagnosis was based almost exclusively on clinical signs without confirmatory laboratory investigations. Despite the magnitude of the problem in El-Gadarif State, no information is currently available with regard to the epidemiology of the disease in this State. El-Gadarif State is one of the largest commercial centers in the Sudan. The objective of the present investigation is to estimate the prevalence of DENV antibodies, and determine the potential risk factors associated with seropositivity among residents of El-Gadarif State., Methods: A cross sectional study was conducted in a total of 701residents randomly selected from all 10 localities in El-Gadarif State. The sera from the 701 residents were tested for the presence of DENV-specific immunoglobulin G (IgG) antibodies using a commercially available Anti-dengue IgG enzyme-linked immunosorbent assay (ELISA)., Results: Among the 701 residents, 334 residents (47.6%) were seropositive for DENV. Mosquito control (OR = 2.73, CI = 1.37-5.87, p-value = 0.001); low income (OR = 2.31, CI: 1.71-6.36, p value = 0.032); sleeping out-doors (OR = 3.73, CI = 2.63-6.23, p-value = 0.013), and localities were determined as potential risk factors for contracting DENV infection., Conclusions: The prevalence rate of DENV antibodies among residents of El-Gadarif State is significantly high (47.6%). Further epidemiologic studies including, distribution of mosquito vectors and implementation of improved surveillance are urgently warranted for better prediction and prevention of a possible DENV outbreak in El-Gadarif State, Sudan.

Objective: To explore the correlation between the -31T/C polymorphisms of IL-1β gene and thesusceptibility of Kawasaki disease (KD).
 Methods: The polymorphism at -31C/T site of IL-1β gene was genotyped with the method of polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) in 100 KD patients (KD group) and 100 healthy children (control group). The differences in genotype distribution and allele frequency between the KD group and the control group were analyzed by χ2 test.
 Results: There were significant differences in genotype and allele frequencies for IL-1β gene polymorphism at -31C/T site between the KD group and the control group (all P<0.05). The risk of KD in the KD group with TT genotype was 0.37 times as that with the CT and CC genotypes (χ2=5.65, P<0.005, OR=0.37, 95%CI 0.16 to 0.85). But there was no significant difference in genotype and allele frequencies for IL-1β genepolymorphism at -31 site between the KD group with coronary artery lesion and the KD group without coronary artery lesion(all P>0.05).
 Conclusion: The polymorphism at -31T/C site of IL-1β gene is associated with genetic susceptibility of KD. The KD patients with TT genotype are at low risk.

Background: Rift valley fever (RVF) is a mosquito-borne viral disease of domestic livestock and wild ruminants. In camels RVF may cause abortion among pregnant camels, but is most often asymptomatic among other camels. In this study, a seroepidemiological survey was conducted to determine the prevalence of RVFV antibodies and to identify the potential risk factors associated with RVFV seropositivity among the Sudanese one-humped camel (Camelus dromedaries) in Khartoum State, Sudan. A cross sectional study was conducted in Khartoum State, Sudan, in a total of 240 camels selected randomly from four localities. Sera sampled were tested for the presence of RVFV-specific immunoglobulin G (IgG) antibodies using a competitive enzyme-linked immunosorbent assay (c-ELISA)., Results: RVFV seropositivity was recorded in 23 out of 240 animals, prevalence rate of 9.6 % among camels in Khartoum State. Age (OR = 8.29, p-value = 0.04) and heavy rainfall (OR = 5.36, p value = 0.01) were recorded as potential risk factors for contracting RVF., Conclusions: Older age and heavy rainfall were considered as potential risk factors for seropositivity to RVF. Surveillance for RVF among camels and distribution of mosquito vectors should continue to better understand the clinical signs associated with RVFV infection in camels and provide public health authorities an opportunity to anticipate and prepare for a possible RVF outbreak in Khartoum State, Sudan.

Objective: To report on the clinical presentation and possible risk factors leading to hand sepsis, amputation, management, and outcome in diabetic patients presenting to a multidisciplinary diabetic center in Khartoum, Sudan., Methods: This is a retrospective descriptive study of all diabetic patients presenting with hand sepsis between September 2002 and March 2008 to Jabir Abueliz Diabetic Centre (JADC) in Khartoum, Sudan., Results: A hundred and nineteen diabetic patients with hand sepsis were managed in JADC. The causative agent was unknown in 48.7%, and due to trauma in 42.9%. The most common presentation was cellulitis in 36.1% of patients and deep seated abscess in 29.5%. In 22.7% there was significant sensory neuropathy with loss of perception to 10 gm monofilament nylon. An associated foot ulcer was present in 13.4% of patients. One or more digits amputation was carried out in 17 (14.3%) of patients and hand amputation was unavoidable in 2 (1.7%). Complete healing with good function was achieved in 79%. There was no mortality in this series., Conclusion: Hand sepsis in diabetics is a serious complication, but with early presentation to a specialized diabetic care facility, satisfactory outcome could be achieved.

A 67-year-old man presented with chest tightness and vomiting of one-week duration. On physical examination bowel sounds were heard on the left chest. Plain chest x-ray, barium swallow, and CT scan suggested gastric volvulus with diaphragmatic hernia. At laparotomy there was complete agenesis of the left hemidiaphragm with no diaphragmatic remnants seen and no associated lung hypoplasia. This is an extremely rare condition and careful assessment is needed to differentiate between diaphragmatic hernia and agenesis of the diaphragm as more cases could be diagnosed in the future as a result of good perinatal care of agenesis of hemidiaphragm AHD and long term survival to adulthood.

We present a 47-year-old patient with progressive dysphagia. Upper gastro intestinal endoscopy revealed middle third esophageal ulcer, the histology of which was moderately differentiated carcinoma. The patient underwent 3-stage esophagectomy with cervical gastro esophageal anastomosis. The histopathology revealed Crohn's disease of the esophagus. The clinical features and diagnosis of this rare condition are described, with review of the literature.

A 50-year-old female with squamous cell carcinoma of the lower third of the esophagus underwent an esophagectomy via laparotomy and right thoracotomy. She developed a major anastomotic leak on the third postoperative day. The chest tube slipped out on the 10th postoperative day and a segment of Taenia saginata tapeworm came out through the tube drain site and was extracted. She was given praziquantel tablets treatment; after which the leakage dropped dramatically and ceased completely after one week. Patients scheduled for esophagectomy who experienced recurrent abdominal pain in areas endemic with a tapeworm need to be screened for taeniasis before surgery.

We report a case of giant cell tumor of the sacrum, presenting with sacral pain, swelling, and change of bowel habits. Rectal examination revealed a huge retrorectal mass fixed to the sacrum but not to the wall of the rectum. Abdominal ultrasonography, computed tomography CT scan, and magnetic resonance imaging MRI showed a huge pelvic mass invading the sacrum. Exploration via posterior sacral approach was not successful due to both, extensive bleeding and difficult accessibility. Re-exploration was carried out 2 days later with the patient in lithotomy position. Using abdomino-sacral approach the mass together with part of the sacrum and the whole coccyx were excised. Histopathology reported giant cell tumor of the sacrum with no evidence of mitosis. The patient was symptomless 12 months after surgery and on follow up.

A 24-year-old patient had a long history of low backache. After examination he was found to have a presacral mass grossly displacing the rectum anteriorly. Surgical exploration revealed a large rounded mass (20x17x10cm) occupying the presacral space and adherent to the sacral promontory. The mass was totally excised. The histology was a benign fibroma. The patient persued an excellent post-operative course and has remained symptom free for one year now.