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On March 2020, the WHO declared coronavirus disease 2019 (COVID-19) pandemic. COVID-19 is associated with various clinical syndromes, with electrolytes imbalances involved. This review aims to quantify the prevalence and outcomes of hyponatremia among COVID-19 patients, as well as to review the underlying pathophysiological mechanisms of hyponatremia among these patients.Using Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines, we conducted a systematic literature search using the electronic databases of Google Scholar, MEDLINE (PubMed), WHO Virtual Health Library, and ScienceDirect, without limitations regarding gender, geographical area, race or publication date, up until December 13, 2021. Primary outcomes measured were mortality, intensive care unit (ICU) admission, assisted ventilation need, and length of hospital stay (LOS). Secondary outcome was the mechanism underlying hyponatremia among COVID-19 patients.From a total of 52 included studies, 23 underwent quantitative analysis. For the primary outcomes; proportions, odds ratios (OR), and standardized mean difference (SMD) were calculated using random effects model. The prevalence of hyponatremia was found to be 25.8%. Hyponatremia was found to be significantly associated with increased odds for mortality (OR = 1.97[95% CI, 1.50-2.59]), ICU admission (OR = 1.91 [95% CI, 1.56-2.35]), assisted ventilation need (OR = 2.04 [95% CI, 1.73-2.38]), and with increased LOS (SMD of 5.74 h [95% CI, 0.092-0.385]). Regarding the mechanisms underlying hyponatremia, syndrome of inappropriate anti-diuretic hormone secretion (SIADH) was most commonly reported, followed by adrenal insufficiency, and finally hypovolemic hyponatremia due to gastrointestinal losses.Hyponatremia among COVID-19 patients is generally associated with poor outcomes, with SIADH being the most common underlying mechanism.

Sickle cell disorders are the most common hemoglobinopathies worldwide. Clinical variability of sickle cell disease (SCD) and susceptibility to its complications have been attributed to hematologic, genetic, and other influencing factors. This review aimed to provide further summary and analyses of the prevalence and factors associated with cholelithiasis among patients with SCD. A systematic database search was conducted in MEDLINE (PubMed), ScienceDirect, Google Scholar, World Health Organization Virtual Health Library, Cochrane Library databases, and System for Information on Gray Literature in Europe (SIGLE). Pooled prevalence, odds ratio (OR), and standardized mean difference (SMD) with the corresponding 95% confidence interval (CI) were calculated using Comprehensive Meta‐Analysis Software version 3.3. A total of 34 studies that fulfilled the eligibility criteria were included in the analyses. The overall prevalence of cholelithiasis among SCD patients was 25.3% (95% CI 19.4–32.3%). The risk of developing cholelithiasis was significantly associated with lower total hemoglobin level (SMD = −0.45; P = 0.002), lower hemoglobin F (HbF) level (SMD = −0.85; P = 0.003), higher total serum bilirubin level (SMD = 1.15; P, This meta‐analysis showed that up to a quarter of all sickle cell disease patients are susceptible to cholelithiasis. The risk of developing cholelithiasis is significantly associated with older age, lower total hemoglobin level, lower hemoglobin F level, higher total serum bilirubin level, higher reticulocytes count, and UDP‐glucuronosyltransferase‐1A1 enzyme (UGT1A1) promoter polymorphism.

Introduction Biliary atresia (BA) is the most common indication of liver transplantation in children. Several reports attributed BA to both prenatal and perinatal aetiologies, including a viral infection-induced auto-immune response that targets the bile ducts. Cytomegalovirus (CMV) remains the most common virus being linked to BA. This meta-analysis estimates to what extent CMV infection is detected in patients with BA. Method This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), ScienceDirect, and Google Scholar were used for the systematic search. Random effects model was used to estimate the pooled prevalence estimate with the corresponding 95% confidence interval (CI) using StatsDirect statistical software. Results A total of 13 studies (covering 419 patients) that fulfilled the eligibility criteria were included in the meta-analysis. The pooled overall prevalence of CMV infection in patients with BA was 24.5% (95% CI 11.9 %– 33.9%). Conclusions The available data demonstrate that the detection of CMV infection is common in infants with BA. There is still a need for large studies with appropriate controls to examine various aspects of the association between CMV infection and BA.

Background: Surgical site infections (SSIs) are common healthcare-associated infections and associated with prolonged hospital stays, additional financial burden, and significantly hamper the potential benefits of surgical interventions. Causes of SSIs are multi-factorials and patients undergoing gastrointestinal tract (GIT) procedures carry a high risk of bacterial contamination. This study aimed to determine the prevalence, associated factors, and causing microorganisms of SSIs among patients undergoing GIT surgeries.Methods: A hospital based, cross-sectional study conducted at Soba University Hospital (SUH) in Khartoum, Sudan. We included all patients from all age groups attending the GIT surgical unit at SUH between September-December 2017. We collected data about the socio-demographic characteristics, risk factors of SSI, and isolated microorganisms from patients with SSIs. Data analysis was done using the SPSS software version 20 (SPSS Inc., Chicago, IL, USA). A Chi-square test was conducted to determine the relationship between the independent categorical variables and the occurrence of SSI. The significance level for all analyses was set at p < .05.Results: A total of 80 participants were included in the study. The mean age was 51 +/- 16 years and most of the patients (67.5%) did not have any chronic illness prior to the surgical operation. Most of them (46.3%) of them underwent large bowel surgery. Twenty-two patients (27.5%) developed SSI post operatively and superficial SSI was the most common type of SSIs (81.8%). Occurrence of SSI was found to be associated with long operation time (p > .001), malignant nature of the disease (p > .001), intra-operative blood loss (p > .001), and intra-operative hypotension (p =.013). The most prevalent microorganism isolated from SSI patients was E coli (47.8%), followed by Enterococcus fecalis (13.0%) and combined Pseudomonas aeruginosa + E coli infection (13.0%).Conclusion: The results showed a high prevalence of SSIs among patients attending the GIT unit in SUH and the most prevalent microorganism isolated from them was E coli. Measures should be taken to reduce the magnitude of SSI by mitigating the identified associated factors.

Background Trachoma is a common infectious cause of blindness worldwide. Although it has largely now disappeared from developed countries, it is still endemic in many developing countries. We aimed to highlight clinical stages and common related socio-demographic and household characteristics among patients with trachoma in Sudan. Methods A hospital-based case series descriptive study was conducted at Makah Eye Complex and Abdalfadeel-Almaz hospital in Khartoum, Sudan. We included all Trachoma patients from all age groups attending the two eye care hospitals in the period from 1st to 31st March 2015. Data was collected through clinical examination, hospital records, and face to face interview using a structured questionnaire, Also, we conducted a review of the literature to highlights the epidemiological aspect of trachoma in Sudan, using the databases of MEDLINE (PubMed) and Google Scholar. Results In this case series, we identified 125 patients with trachoma in the study period. Most of them were aged more than 50 years old (78.4%). Half of the participants (56%) were positive for active trachoma, 40.8% of them were having Trachomatous Trichiasis (TT), and 56% of them have Trachoma Follicles (TF). Majority of the patients have low socioeconomic status and poor personal and environmental hygiene (88%), (44%) and (74.4%), respectively. Conclusion Low socioeconomic status and poor personal and environmental hygiene are common socio-demographic and household characteristics among patients with trachoma. Despite the progress that has been made towards disease elimination, trachoma is still a public health problem in Sudan. Our review highlights the magnitude of trachoma and the progress towards its elimination in Sudan.

Vitamin D Deficiency (VDD) is reported to be more frequent with serious clinical outcomes in patients with Sickle Cell Disease (SCD). There is a wide disparity in data in the existing literature regarding the prevalence and risk of VDD in patients with SCD. These data require further summary and analyses for better accuracy. This review aimed to assess the association between VDD and SCD, and was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Medline/PubMed, World Health Organization Virtual Health Library, ScienceDirect, and Google Scholar were used for the systematic search. A random effects model was used to estimate the pooled prevalence, Risk Ratio (RR), and Standardized Mean Difference (SMD) estimates with the corresponding 95% Confidence Interval (CI) using OpenMeta Analyst software version 10.10 (Tufts Medical Center, Boston, MA, USA). Twenty-five studies fulfilled the eligibility criteria. The prevalence of VDD among patients with SCD was 63.8% (95% CI, 52.5–75.1). The risk of VDD among patients with SCD was more than two times that of the general population (RR = 2.129; 95% CI, 1.024–4.423; p < 0.001). Serum vitamin D levels were significantly lower in SCD patients than in their controls (SMD = −1.883: 95% CI, −3.006 to −0.760; p < 0.001). This review provides a comprehensive view of the association between vitamin D status and SCD.

Objectives: Treating infections caused by Pseudomonas aeruginosa is challenging. In addition to its intrinsic ability to develop resistance to multiple classes of antibiotics, it also produces Extended Spectrum β lactamases (ESBL). This study aimed to determine the antimicrobial susceptibility pattern and to determine the ESBL status among the P. aeruginosa isolates from patients at two public military hospitals in Khartoum, Sudan.Results: A total of 34 isolates of P. aeruginosa obtained from patients with diabetic septic foot wounds were tested for their antibiotic sensitivity patterns. Resistance occurred most commonly to Ceftazidime (35%), followed by Ciprofloxacin (20.6%) and Piperacillin (14.7%). We found that 17.6% of the P. aeruginosa isolates were ESBL producers and all of these isolates were sensitive to Meropenem. The chi-squared test showed a significant association between the ESBL status and antimicrobial resistance to Amikacin, Ceftazidime, and Piperacillin. The independent T-test showed a significant association between the ESBL status and resistance to Cefepime. The presence of drug-resistant P. aeruginosa poses a serious health problem. This study suggests sparing the Carbapenems for the ESBL producing P. aeruginosa in our setting. Our findings highlight the need for effective surveillance and antibiogram-guided antibiotic prescription.

Treating infections caused by Pseudomonas aeruginosa is challenging. In addition to its intrinsic ability to develop resistance to multiple classes of antibiotics, it also produces extended-spectrum β-lactamase (ESBL). Continuous update of the antibiograms is required to cope with the rate of the emergence of antibiotic resistance. This study aimed to determine the antimicrobial susceptibility pattern and to determine the frequency of ESBL production among the P. aeruginosa isolates from patients at two public military hospitals in Khartoum, Sudan. A total of 34 isolates of P. aeruginosa obtained from patients with diabetic septic foot wounds were tested for their antibiotic sensitivity patterns. Resistance occurred most commonly to ceftazidime (35%), followed by ciprofloxacin (20.6%) and piperacillin (14.7%). We found that 17.6% of the P. aeruginosa isolates were ESBL producers, but all of these isolates were sensitive to meropenem. The chi-squared test showed a significant association between the ESBL production and antimicrobial resistance to amikacin, ceftazidime, and piperacillin. Our findings strengthen previous reports in which aminoglycosides (amikacin) and carbapenems (meropenem) were found to be highly effective against P. aeruginosa. Our findings highlight the need for effective surveillance and antibiogram-guided antibiotic prescription.

Background Methicillin-resistant staphylococcus aureus (MRSA) infection is increasingly being reported among patients with cystic fibrosis (CF) and contributes to pulmonary morbidity in CF, with poorer prognosis. The aim of this study was to assess the prevalence of MRSA infection in patients with CF. Methods We conducted this study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), ScienceDirect, Google Scholar and OpenGrey were searched to recruit the relevant articles. Pooled prevalence with the corresponding 95% confidence interval (CI) was calculated using OpenMeta Analyst software, and heterogeneity among studies was estimated using the I2 statistics. Results According to our inclusion criteria, 27 studies included a total of 47,413 patients were analyzed. The pooled prevalence of MRSA in patients with CF was 15.2% (95% CI 9.70%– 20.7%). Subgroup analyses and meta-regression showed that the prevalence of MRSA in patients with CF was significantly associated with different geographical areas (P

Prevention of asthma attacks is one of the major challenges of public health. Sufficient knowledge and positive attitudes and correct practices are crucial for the prevention of exacerbations. However, there is insufficiency of information in regard to these in Sudan. The aim of this study was to assess the knowledge and to identify the attitude and practice of mothers of asthmatic children concerning their use of inhalers, compliance to preventers and to measure its effect on the severity of the disease in their children. A sample of 100 consecutive mothers of asthmatic children was enrolled. Any mother with a child diagnosed with bronchial asthma for more than 3 months, and who attended the outpatient clinic of paediatric asthma in Soba or Ahmed Gasim hospitals or the Emergency room of Ahmed Gasim or Ibrahim Malik hospital in the period from 1st to 31st of October 2016 was eligible to be included. Asthma was believed to be infectious by 7% of the respondents. 17% of the mothers thought asthma was preventable by a vaccine. 21% found inhaler use unacceptable. Half of the mothers (50%) did not use the inhaler correctly. Most of the mothers (69%) did not use the inhaler if symptoms were mild and 53% didn’t use preventers. The severity of asthma was found to be significantly associated with the attitude and practice of mothers (P

Background. Parvovirus B19 (B19 V) infection had been reported to be more frequent with serious clinical outcomes in patients with sickle cell disease (SCD) than in the general population. There is a wide variation in data among the existing literature regarding the seroprevalence of B19 V in patients with SCD. These data require further summary and analyses for better accuracy. This systematic review and meta-analysis was done to estimate the seroprevalence of B19 V in patients with SCD. Methods. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE/PubMed, Virtual Health Library (VHL), ScienceDirect, Google Scholar, and OpenGrey were used for the systematic search. The random-effects model was used to estimate the pooled prevalence with the corresponding 95% confidence interval (CI) using OpenMeta Analyst software. Publication bias was estimated based on Begg’s test, Egger’s test, and examination of the funnel plot. Subgroup analyses and metaregression were used to explore the moderators of heterogeneity between studies. Results. A total of 18 studies including 2890 patients were analyzed. The overall IgG seroprevalence of B19 V infection among patients with SCD was found to be 48.8% (95% CI 39.5%–58.0%). Evidence of publication bias was not detected. Evidence of acute viral infection detected by positive IgM antibodies among the screened SCD patients was found in 8.30% (95% CI 5.20%–11.4%) of them. There was a statistically significant association between seroprevalence of B19 V and geographical areas. Conclusion. There was a high prevalence of B19 V in patients with SCD. Healthcare providers need to be aware of the magnitude of B19 V infection in patients with SCD to ensure effective management. This review could provide a comprehensive view of B19 V prevalence in this susceptible population.

Background Hepatitis B virus (HBV) infection creates a global health burden with significant morbidity and mortality. Healthcare workers, including nurses and midwives, are at higher risk of acquiring the disease. While health-related behaviours are affected by different aspects of knowledge, attitude, and practices (KAP), there are few studies examining the KAP level of healthcare workers towards HBV infection in Sudan. The purpose of this study was to examine the KAP level of nurses and midwives towards HBV virus infection in Khartoum, Sudan. Methods A cross-sectional descriptive hospital-based study was conducted in two public maternity hospitals (Saudi and Saad Abul-Eleella hospitals) in Khartoum state of, Sudan. A pre-tested structured questionnaire was constructed and implemented to examine KAP towards HBV infection. Statistical Package for Social Sciences (SPSS) version of 21 was utilized to conduct statistical analysis and examine the data at hand. Chi-square test was used implemented to determine the relationship between categorical variables. Results A total of 110 nurses and midwives from the both hospitals participated in this study. More than half of the respondents (58.2%) had an average level of knowledge, two-third of the respondents had a safe practice, and the majority of the respondents had a favourable attitude towards HBV preventive measures. Approximately half of the participants (51.8%) had a history of needle stick injuries. Half of the participants had inaccurate concepts about post exposure prophylaxis to HBV infection, while more than half of the nurses and midwives didn’t complete the vaccination schedule for HBV. Conclusion Most of the nurses and midwives in Saudi and Saad Abul-Eleella hospitals were aware of HBV infection. However, a significant proportion of the participants lack the requisite knowledge about post exposure management. The study revealed a low level of HBV vaccination coverage rate and a high rate of needle stick injuries. Further strategies for preventing workplace exposure, training programs on HBV infection, including post exposure prophylaxis, and increasing vaccination coverage rate of all HCWS are highly recommended.

Objective This meta-analysis was done to estimate the prevalence of autoimmune thyroid diseases (ATDs) in Turner Syndrome patients, and to determine the clinical status of thyroid autoimmune diseases that occur frequently in association with Turner Syndrome. Results A total of 18 studies were included in the meta-analysis. The pooled overall prevalence of autoimmune thyroid diseases in Turner Syndrome patients was 38.6% (95% CI 29.7–47.6%), with 12.7% (95% CI 9.30–16.1%) of them had clinical hypothyroidism and 2.6% (95% CI 1.5–3.8%) had hyperthyroidism. I-squared test had a high result of heterogeneity. In subgroup analyses, the prevalence of ATDs was higher in the European region than Asian region. Autoimmune thyroid diseases are commonly associated with Turner Syndrome. Early detection of thyroid diseases by optimal screening among children with Turner Syndrome is required to ensure effective management. Electronic supplementary material The online version of this article (10.1186/s13104-018-3950-0) contains supplementary material, which is available to authorized users.