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The Sudan Journal of Medical Sciences is a leading scholarly medical journal in Sudan that publishes high-quality research addressing health challenges faced by the Sudanese health community. Despite the challenges caused by the ongoing conflict in Sudan, the journal has continued to collect and publish scholarly output, with a significant increase in readership and article views in 2023. The journal has a diverse readership from 203 countries, with the largest number of readers based in the United States. The journal has faced internet connectivity issues and financial obligations, but has received support from donors and organizations to maintain its operations. The journal aims to represent the wide spectrum of the medical academic community in Sudan and has an ongoing call for support. [Extracted from the article]

Objective: Prospective data on determinants of muscle strength impairment and quality of life in patients with various subtypes and severity of endogenous hypercortisolism are lacking. Design: Single-center cross-sectional study, 2019 to 2022. Methods: Patients with Cushing syndrome (CS) and mild autonomous cortisol secretion (MACS) were assessed with clinical and biochemical severity scores, muscle function (nondominant hand grip strength and sit-to-stand test), and quality of life (Short Form-36 [SF36] and CushingQoL). Referent subjects were recruited from the local population undergoing abdominal imaging for reasons other than suspected adrenal disorder. Results: Of 164 patients, 81 (49%) had MACS, 14 (9%) had adrenal CS, 60 (37%) had pituitary CS, and 9 (5%) had ectopic CS. Median age was 53 years (interquartile range: 42-63 years), and 126 (77%) were women. The SF36 mental component score was similarly low in patients with MACS vs CS, but physical component score was lower in CS when compared to MACS (mean of 34.0 vs 40.5, P = .001). Compared to MACS, patients with CS had lower scores on the standardized CushingQoL (mean of 47.1 vs 34.2, P < .001). Compared to referent subjects, patients with MACS demonstrated reduced muscle strength, similar to patients with CS (mean sit to stand Z-score of -0.47 vs -0.54, P = .822). Clinical severity (r = -0.22, P = .004) but not biochemical severity was associated with sit-to-stand test performance. Conclusions: Both patients with overt CS and MACS demonstrate reduced muscle strength and low quality of life. The clinical severity score utilized is associated with both physical and psychosocial components of CushingQoL and with the physical component of SF36. [ABSTRACT FROM AUTHOR]

Context: Current evidence on determinants of quality of life (QoL) in patients with adrenal insufficiency (AI) is limited. Objective: This work aimed to identify the determinants of QoL in different subtypes of AI. Methods: This multicenter cross-sectional survey study was conducted using a patient-centered questionnaire, the Short Form-36. Results: Of 529 participants, 223 (42.2%) had primary AI, 190 (35.9%) had secondary AI, and 116 (21.9%) had glucocorticoid-induced AI. Median age was 58 years (interquartile range: 43-68 years) and 342 (64.8%) were women. In multivariable analyses, patients were more likely to report worse physical scores if they were women (odds ratio [OR]: 3.3; 95% CI, 1.8-6.0), had secondary AI or glucocorticoid-induced AI (OR: 2.5; 95% CI, 1.4-4.3), had shorter duration of AI (OR: 2.0; 95% CI, 1.1-3.6), were treated with more than 25 mg hydrocortisone equivalent daily (OR: 2.3; 95% CI, 1.2-4.6), had more comorbidities related to glucocorticoid excess (OR: 2.3; 95% CI, 1.3-4.0), reported a higher financial burden from AI (OR: 2.1; 95% CI, 1.3-3.6), and reported difficulties with AI management (OR: 2.5; 95% CI, 1.2-5.2). Women (OR: 2.1; 95% CI, 1.08-4.0), shorter duration of AI (OR: 2.4; 95% CI, 1.4-4.3), higher financial burden (OR: 2.3; 95% CI, 1.3-4.0), difficulties with AI management (OR: 2.6; 95% CI, 1.4-4.9), and lack of family support (OR: 9.1; 95% CI, 2.3-33.3) were associated with worse mental component scores. Conclusion: In patients with AI, QoL could be improved by addressing certain determinants, such as avoiding GC overreplacement, providing in-depth education on self-management, offering more comprehensive insurance coverage, and ensuring better family support. [ABSTRACT FROM AUTHOR]

Context: The COVID-19 pandemic has impacted healthcare environment.Objective: To determine the impact of the pandemic on self-reported outcomes in patients with adrenal insufficiency (AI).Design and Setting: Prospective longitudinal survey study at 2 tertiary centers.Participants: Patients with AI.Intervention: Patient-centered questionnaire.Main Outcome Measures: Depression Anxiety Stress Scales-21, Short Form-36, and AI self-management.Results: Of 342 patients, 157 (46%) had primary AI, 109 (32%) had secondary AI, and 76 (22%) had glucocorticoid-induced AI. When compared to prepandemic, daily glucocorticoid dose and number of adrenal crises did not change. However, patients reported a higher financial impact from AI (34% vs 23%, P = 0.006) and difficulty accessing medical care (31% vs 7%, P < 0.0001) during the pandemic. A third of patients reported difficulty managing AI during the pandemic. After adjusting for duration and subtypes of AI, younger patients [odds ratio (OR) 2.3, CI 95% 1.3-4.1], women (OR 3.7, CI 95% 1.9-7.1), poor healthcare access(OR 4.2, CI 95% 2.3-7.7), lack of good insurance support (OR 2.8, CI 95% 1.3-5.9), and those with a higher financial impact (OR 2.3, CI 95% 1.3-4.3) reported greater difficulties managing AI. Patients were more likely to report a higher anxiety score (≥8) if they found managing AI challenging during the pandemic (OR 3.0, CI 95% 1.3-6.9), and had lower Physical Component Summary (OR 4.9, CI 95% 2.2-11.0) and Mental Component Summary (OR 4.1, CI 95% 1.8-9.5) scores prior to the pandemic.Conclusions: A third of patients with AI reported difficulties with management of AI during the pandemic, particularly in younger patients, women, and those with poor healthcare access. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine asthma disparities at the intersection of four sociodemographic characteristics, inhaled substance use, and bias-based bullying as metrics of stigma. We hypothesized that high prevalence groups for asthma would be those with marginalized social positions and those reporting bullying experiences, independent of inhaled substance use., Method: The analytic sample ( N = 90,367) included eighth, ninth, and 11th grade students who participated in the 2022 Minnesota Student Survey. Exhaustive Chi-square Automatic Interaction Detection tested all combinations of sociodemographic characteristics (gender identity, sexual orientation, racial/ethnic identity, and access to resources), inhaled substance use (none vs. any), and bias-based bullying about sexuality, gender identity/expression, racial identity, and weight/size to predict mutually exclusive groups of youth based on self-reported asthma diagnosis., Results: Approximately 15% of the sample reported asthma. Sexually, gender, and racially/ethnically diverse youth reported higher rates of asthma relative to their heterosexual, cisgender, and White counterparts. High prevalence groups for asthma (rates between 24% and 41%) were characterized by having multiple marginalized identities, experiencing bias-based bullying, and engaging in inhaled substance use. Three of the 10 intersectional groups with a high prevalence of asthma were not inhaled substance users., Conclusions: These findings suggest that stigma may help explain the asthma disparities among marginalized youth. Efforts to reduce asthma disparities in marginalized youth should move beyond pathologizing the individual through overfocusing on health behaviors and attend to root causes, like experiences of stigma. Future studies should examine systemic inflammation as the potential connection between stigma and asthma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).