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The aim of our study was to investigate the relationship between the ACE I/D and PAI-1 4G/5G polymorphisms and RPL in Sudanese women. Methods and Results: A total of 232 people participated in this case-control study, including 119 women who had been diagnosed with RPL (Case group) and 113 healthy women (Control group). The case group (RPL) consisted of Sudanese women (mean age of 31.3+5.9 years) who had at least three unfavorable pregnancy outcomes. Women in the control group (Control) were matched by age (mean age of 30.3+5.4 years), had at least two healthy pregnancies, and had no history of unfavorable pregnancy outcomes or recurrent losses. Genomic DNA samples were isolated from the whole blood by using the GF-1 Blood DNA Extraction Kit (Vivantis Technologies Sdn. Bhd., Malaysia) according to the manufacturer`s protocol. The status of the PAI-1 4G/5G and ACE I/D polymorphism was determined by PCR. Analysis of the multiplicative and additive models for the ACE I/D polymorphism showed a significant risk of RPL with the carriage of the D allele (OR=2.07, 95% CI: 1.28-3.35, P=0.003) and the homozygous DD genotype (OR=2.40, 95% CI: 1.34-4.29, P=0.008). The multiplicative and additive models for the PAI-1 4G/5G polymorphism showed a significant risk of RPL with the carriage of the 4G allele (OR=3.11, 95% CI: 2.12-4.58, P=0.000) and the homozygous 4G/4G genotype (OR=3.09, 95% CI: 1.77-5.39, P=0.000). However, the carriage of risk-polymorphic markers, the ACE I/D and PAI-1 4G/5G polymorphisms, was not associated with the number of RPL. The combined carriage of the homozygous DD genotype and heterozygous ID genotype of the ACE I/D polymorphism with the homozygous 4G/4G genotype of the PAI-1 4G/5G polymorphism occurs significantly more often in RPL women than healthy women (P=0.000 and P=0.006, respectively). Carriage of the PAI-1 5G/5G genotype in healthy women was not associated with the ACE I/D polymorphism. Conclusion: Testing for the ACE I/D and PAI-1 4G/5G polymorphisms should be part of the standard examination for patients with RPL.

Background: Smoking-related hemodynamic events may adversely influence renal function. The aim of this study was to evaluate renal impairment biomarkers among healthy people influenced by cigarette smoke. Methods and Results: In this case-control study, 90 subjects were enrolled: 60 were smokers, and 30 were non-smokers (apparently healthy control). Serum CysC was measured using a semi-automated, specific protein analyzer Mispa-i2 (Germany). Serum creatinine and MAU were assayed in the fully automated biochemistry analyzer (Mindray BS380). The mean concentration of CysC was significantly higher in cigarette smokers than in non-smokers (0.793±0.125 vs. 0.619±0.103, P=0.000). Also, the mean of MAU and serum creatinine levels were significantly higher in cigarette smokers than in non-smokers (18.33±3.41 vs. 12.70±0.517, 1.06±0.161 vs. 0.810±0.058, respectively, P=0.000 in both cases). The mean concentration of CysC and MAU was significantly greater in heavy smokers than in light smokers (P=0.000 and P=0.001, respectively). Serum CysC and MAU levels were positively correlated with the age of cigarette smokers (r=0.734 and r=0.730, respectively; P=0.000 in both cases) and the duration of smoking (r=0.773 and r=0.790, respectively; P=0.000 in both cases). Conclusion: cigarette smoking increases the specific renal biomarkers considered risk factors for renal impairment. Using such inflammatory biomarkers as diagnostic tools can be a necessary precaution in the development of chronic kidney disease caused by smoking and in the avoidance of acute renal consequences linked to cigarette smoking.

Background: Prostate cancer (PC) is the most common cancer among men in Sudan. It was ranked fourth among all cancer treatment centers in Khartoum. This study aimed to assess knowledge and attitude toward PC among male medical students in their final and semifinal years at the University of Khartoum. Methods and Results: A descriptive cross-sectional online survey was conducted at the University of Khartoum (Faculty of Medicine) on semifinal and final-year male medical students from March 2022 until May 2022. Data were collected from medical students, using a standardized, pretested, coded questionnaire that contained close-ended questions. The questionnaire was distributed online to the medical students using Google Forms. Knowledge levels were determined using 10 questions on risk factors, signs and symptoms, prevention, treatment, and complications of PC. A total of 131 participants received questionnaires, and the response rate was 100%. The results are presented in chronological order in the way they were analyzed, starting with sociodemographic characteristics of the participants, sources of information on PC, knowledge levels (low, medium, and high) of PC, and attitude levels (positive, negative) relating to the year of study. All medical students in the last 2 years have heard about PC, and medical students overwhelmingly (88.5%) believe that early detection of PC through screening improves survival. Almost all the respondents in our study indicated their willingness to go for PC screening (87.8%), and the rest of the respondents’ attitudes about the importance of PC and treatment were positive. Conclusion: Most students have sufficient knowledge about prostate cancer, its risk factors, complications, and treatment. Medical students are an important population in studying the determinants of screening for prostate cancer.

The purpose of this study was to determine the etiology and cytological patterns of serous effusions among Sudanese patients. Methods and Results: This descriptive study was carried out in hospitals of Khartoum state in the period from February 2019 to June 2020. One hundred and seventy-eight patients “clinically and/or radiological” diagnosed as having an accumulation of serous effusions were included in this study. Smears were prepared and stained according to the conventional pap staining procedure. The majority of the study population (121[68%]) had malignant effusion (MEs), and the other group (57[32%]) - benign effusions (BEs). Among patients with MEs, breast cancer was the major etiology (75[62%]), followed by lung (23[19%]), GIT (12[9.9%]), and thyroid cancers (11[9.1%]), while among patients with BEs, parapneumonic conditions were the main factor (28[49.1%]), followed by tuberculosis (18[31.6%]) and pulmonary embolism (11[19.3%]). The majority of patients with MEs were pleural effusion (109[90.1%]), followed by peritoneal effusion (12[9.9%]), whereas no patients in this group had pericardial effusion. Pleural effusion (29[50.9%]) was also the major one among patients with BEs, followed by peritoneal (21[36.8%]) and pericardial effusions(7[3.9%]). Conclusion: Malignant serous effusion is commonly seen among patients with malignant tumors; pleural effusions presented a large proportion, especially among females with breast cancer. Thoracentesis and cytological methods (i.e., conventional smear and cell block technique) should be the first line for the diagnosis of malignant pleural effusions, along with confirmatory adjunct techniques such as immunohistochemistry and immunocytochemistry.

The unanticipated outbreak of the COVID-19 pandemic has shocked the world in terms of both lives and livelihood. SARS-CoV-2 virus primarily affects the respiratory system, although other organ systems are also involved. Early diagnosis followed up by a retrospective analysis and tracking of a few markers relevant to the immunological status of the individual may aid in determining the state of the patient's disease prognosis. The aim of the present study was to evaluate immunological parameters such as neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP), and D-dimer, taking into account the patient's age and oxygen saturation level. Our retrospective analysis of clinical data revealed that such parameters as CRP, D-dimer, and NLR should be taken into consideration to predict severe COVID-19-related complications. The data obtained indicate that patients over age 60 are especially vulnerable to severe COVID-19.