Faculty of Medicine كلية الطب

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A Review of Sudanese Maternal Deaths
(جامعة الشيخ عبدالله البدري, 2022-09-06) Nezar Mohammed Kheir Mohammed; Taha Umbeli Ahmed; Mohammed Ahmed Ibrahim Ahmed; Nahla Ahmed Mohammad Abdelrahman; Mosab Nouraldein Mohammed Hamad
Abstract: Background: The fifth Millennium Development Goal aims for a decrease in maternal mortality and universal access to high quality reproductive health care. Every year, around a third of a million women die as a result of pregnancy-related complications. Three quarters of these deaths might have been avoided. One of the most important markers of mother and child health care is the Maternal Mortality Ratio. One of the most significant aims of the national family welfare program is to reduce maternal fatalities are thought to be preventable. Objective: The study's focus is to document, investigate, and report the events and circumstances behind maternal fatalities, as well as to study maternal deaths in River Nile State in order to identify the maternal mortality rate and causes of death. Methodology: This is a hospital and community-based research that took place from January to December 2018 at River Nile State. Information on every maternal death was obtained using a questionnaire which was filled out and rechecked to completely cover State, and then analyzed using SPSS version 20. Results: The overall number of live births was 25988, with 29 incidents of maternal death. 112/100000 live births was the death rate. 27 of the patients (93%) died in a hospital, whereas two instances (7%) died at home. Obstetric hemorrhage was the leading cause of maternal death in seven cases (24.1%), followed by hypertensive disorders in seven cases (24.1%), sepsis in four cases (17.2%), indirect obstetric causes in three cases (10.3%), embolism (PE & AFE) in three cases (10.3%), unclassified causes in four cases (13.7%), and abortion in one case (3.4 %). The bulk of the cases were delayed at home (14 cases, 48.3%), with 10 cases (34.4%) having no delay and five (17.2%) being delayed in reaching hospitals. Unfortunately, 19 instances (65.5%) died as a result of preventable causes. Conclusion: In 2018, the maternal death rate in River Nile State was 112/100,000 live births, which was higher than in the previous report. Maternal fatalities were mostly caused by hemorrhage, hypertensive diseases, and sepsis. The bulk of deaths were postponed until they reached their final destination. Keywords: Maternal, Death, Atbara, River Nile, Sudan. Abbreviations: MMR; Maternal Mortality Ratio, AFE; Amniotic fluid embolism, LB; Live Births, SMIs; Safe Motherhood Initiatives, MDG; Millennium Development Goal, HIV; Human Immune Virus, SHHS; Sudan Household Health Survey, MDR; Maternal Death Ratio, WHO; World Health Organization ANC; Antenatal Care, CS; Cesarean Section, FSB; Fetal stillbirth, MSB; Macerated stillbirth, PND; Perinatal Neonatal Death, EmONC; Emergency Obstetrics and Neo-natal Care, PHC; Primary Health Care, PPH; Post-Partum Hemorrhage, APH; Anti-Partum Hemorrhage
Antimicrobial Activity of Azithromycin and Erythromycin against Streptococcus Pyogenes Isolated from Sore Throat Patients in Shendi, Sudan
(SAR Publiher, 2024-01-03) Mosab Nouraldein Mohammed Hamad
Background: Streptococci is considered one of the predominant flora colonizing the respiratory tract of humans. The group A Streptococci (GAS) causes the broadest range of diseases that can lead to the asymptomatic carriage, superficial infection of the upper respiratory tract mainly throat infection. Objectives: The study was carried out to assess the antimicrobial activity of azithromycin and erythromycin against Streptococcus pyogenes (Group A) isolated from sore throat patients. Methods: Sixty-one throat swab samples from both sexes were collected randomly from different clinics in Shendi, Sudan from patients with clinical findings suggestive of throat infection between August to November 2021. Streptococcus pyogenes were isolated by standard cultural techniques and identified by using Gram stain and biochemical tests. Also, the antimicrobial activity of Azithromycin and Erythromycin were assessed using the disc diffusion method. Result: 19 throat swab samples (31%) out of 61 had S. pyogenes growth, whereas 42 (69%) did not. Of the patients, 12 (63.2% of them) were men, and 7, 36.8%, were women. The ages of the infected patients ranged from 1 to 10 years old in 2 (5.3%) cases, 11 to 20 years old in 2 (10.5%), 21 to 30 years old in 15 (78.9%), and 41 to 50 years old in 2 (5.3%) cases. In contrast to the other 5 (26.3%), 14 of them (73.7%) had recurring throat infections. Out of the 19 S. pyogenes isolates that tested positive, only 12 (63.6%) were susceptible to azithromycin and just 7 (36.8%) were resistant. 13 (68.4%) of the 19 S. pyogenes positive isolates were erythromycin sensitive, whereas 6 (31.6%) were resistant. Conclusion: Azithromycin and erythromycin are more sensitive to S. pyogenes, which indicates less excessive usage of these antibiotics in Shendi. Streptococcal infections in the respiratory tract are challenging to treat, and selecting an antibiotic treatment involves numerous considerations. Any isolated strain's susceptibility to antibiotics should be assessed because this is the only way to ensure quick and successful treatment. In order to improve public health, antibiotic therapy should be accompanied by adequate preventive measures, such as training nursing staff to prevent as many nosocomial infections as possible, educating the general public about the importance of hygiene and encouraging them to stop self-medicating and fostering closer scientific collaboration between clinicians and microbiologists
Assessment of Adequacy of Nutritional Support in COVID-19 Patients Receiving Oxygen Therapy in Multi Isolation Centers in Khartoum State and its Relation to Outcomes
(جامعة الشيخ عبدالله البدري, 2022-07-18) Farh Ahmed Elhassan Mohamed; Ihab Babiker Abdulrhman; Ghanem Mohammed Mahjaf; Mosab Nouraldein Mohammed Hamad
Abstract: Background: Beginning in December 2019, the 2019 novel coronavirus disease (COVID-19) has caused a pneumonia epidemic that began in Wuhan, China, and is rapidly spreading throughout the whole world. Nutrition support has become one of the important treatments for severe and critical patients. Objective: To assess the adequacy of nutritional support in COVID-19 patients receiving oxygen support. Methods: A multicenter prospective study enrolled 88 COVID-19 patients receiving oxygen support in Fedail Hospital, Albaraha Hospital, Aliaa Hospital, and Royal Care Hospital during the period from January to April 2021. Data regarding demographics, comorbidities, types of oxygen therapy, vital signs, laboratory investigations, methods of nutrition support, estimated calorie achievement, and outcomes were collected. Nutritional adequacy was assessed by using the Nutritional Risk Screening-2002 (NRS- 2002) test. Results: Among 88 patients, 50(56.8%) were males and 38(43.2%) were females; their mean age was 67±11 years. CPAP (n=28; 32%) and mechanical ventilation (n=27; 27%) were the main types of oxygen therapies. Estimated calories were achieved in only 36(40.9%) of patients and failure to the achievement of estimated calories was commonly due to hypoxia (n=33; 37.5%) and poor appetite (n=23; 26.1%). About 66(75%) patients were adequately nourished, 16(18.2%) were at risk of malnutrition, and 6(6.8%) patients were malnourished. The mortality was significantly associated with malnutrition (P. value= 0.000), and parental feeding modes (P. value= 0.000), and underweighted BMI (mean= 17.8 kg/m2; P. value= 0.000). Moreover, multi-organ failure was significantly correlated with risk of malnutrition (P.value= 0.000), NG feeding (P. value= 0.000) and overweighed BMI (mean= 28.8 kg/m2; P. value= 0.000). Additionally, mortality and multi-organ failure were significantly correlated with hypoalbuminemia among our study subjects (P. value= 0.001). Conclusion: The rates of malnutrition and risk of malnutrition were 6.8% and 18.2% among COVID-19 patients who received oxygen therapy, respectively. Inadequacy of nutritional support or failure in the achievement of estimated calories among our study subjects were commonly due to hypoxia and poor appetite. Mortality was significantly associated with malnutrition, parental feeding modes, and underweighted BMI. Furthermore, multi-organ failure was significantly correlated with the risk of malnutrition, NG feeding, and overweighed BMI. Both, mortality and multi-organ failure were correlated with hypoalbuminemia
Assessment of Allergy Marker Leucocyte (Eosinophil) Count and other Blood Cells Parameters among Workers at Berber Cement Factory, Berber Governorate, River Nile State, Sudan, 2017
(جامعة الشيخ عبدالله البدري, 2017) Mosab Nouraldein Mohammed Hamad
Abstract- Background: This study was conducted at Berber cement factory in barber to assess cement dust exposure and relationship to complete hemogram change and allergic condition among workers. governorate leading to many pathological conditions one of those phenomenons is allergy, certainly among whom worked in cement factories. Objectives: To know the effect of exposure to the dust of cement on blood cells especially allergy Marker leucocytes. Methodology: A total of 120 exposed and 30 non exposed workers were enrolled in this case control study. Result: Allergy marker leucocyte (eosinophil) was increased (eosinophilia) other blood cell parameters were not affected. Conclusion: There is intimate relation between exposure to cement dust and eosinophilia. Recommendations: Furtherer studies are recommended with large sample size and taking the IgE measurement as a priority ofthe followingstudies.
Case Report: Entamoeba Histolytica and Candida Impair Artemisinin-Based Combination Therapy Effect in Malaria Patient
(SAR publisher, 2023-12-28) Mosab Nouraldein Mohammed Hamad
Malaria is an endemic disease in Sudan, and the emergence of antimalarial drugs resistance represent a serious problem affecting the Sudanese population. Acidity reduces absorption of antimalarial drugs and allows for malaria parasites to survive and multiply. Enteric pathogens such as Entamoeba histolytica, candida and Helicobacter pylori may support the growth of Plasmodium falciparum, through inhibition of the absorption of antimalarial agent, such as artemisinin-based combination therapy (ACT)
Clinical Course of Asymptomatic and Mildly Symptomatic COVID-19 Patients Who had A Positive PCR Test in Multicenter in Khartoum
(جامعة الشيخ عبدالله البدري, 2022-05-14) Marawan Izzeldin A.Abdallah; Tarig Elhadi Elsidig; Farh Ahmed Elhassan Mohamed; Ghanem M. Mahjaf; Mosab Nouraldein Mohammed Hamad
Determination of Immunity Status of Vaccinated Health Care Workers against Hepatitis B Virus in Khartoum State, Sudan
(Middle East Research Journal of Medical Sciences, 2024-01-20) Mosab Nouraldein Mohammed Hamad
Background: The vaccination of health care workers (HCWs) for the hepatitis B virus (HBV) is a crucial part of hospital infection control programs. They are considered to be a population at high risk of developing HBV infection due to the high transmissibility of the virus and the risk related to occupational injuries. The risk is particularly high in HCWs with greater exposure to accidental inoculation at work and is related to the duration of professional activity, the characteristics of the healthcare center, and the type of population served. Objectives: The current study was conducted to evaluate the immunity status of the vaccinated HCWs against HBV in Khartoum State. Materials and Methods: This cross-sectional descriptive laboratory-based study was conducted from December 2022 to February 2023. Data were collected through a structured questionnaire regarding age, gender, type of employment, length of employment, and duration of vaccination for each participant. 90 vaccinated HCWs were enrolled in this study; serum samples were collected from each participant; the Enzyme Linked Immuno Sorbent Assay technique was used to detect the anti-HBs level; and the collected data were analyzed using Statistical Package for the Social Sciences (SPSS). Results: This study included 90 healthcare workers, female 70 (77.8%), male 20 (22.2%) ages ranging from 20 to 52 years old, 45 (50%) of them laboratory specialists, and 23 (23.3%). Nursing 17 (18.9%), Dentists 5 (5.6%), and 2.5 (2.2%). The results of the current study reveal that 70% of the studied vaccinated HCWs have a protective level of HBs-Ab. Of these, 23.3% had an anti-HBs titer between 10 and 100 mIU/ml, and the rest, 46.7%, had an anti-HBs titer >100 mIU/ml, while 30% of them were not protective, 22.2% of them were males, and the rest, 77.8%, were females, with a mean age of 30 years. Conclusion: Though many HCWs had been exposed to the virus before or had received vaccinations, the majority of them were seroprotected against the hepatitis B virus. HCWs must be made aware of the prescribed immunization schedule and must be required to receive all recommended vaccinations.
Does Primaquine Become The First Line in the Treatment of Uncomplicated Malaria in Coming Days?
(جامعة الشيخ عبدالله البدري, 2022-02-27) Mosab Nouraldein Mohammed Hamad
Background: Malaria is a major public health problem throughout human history, particularly in the tropical and subtropical countries. Primaquine, introduced in 1950, for preventing relapse and sterilizes infectious sexual plasmodia. Methods: A retrospective study was performed for 610 patients (250 were male and 360 were female), (all ages) to study the efficacy of Primaquine in the treatment of falciparum malaria after receiving this drug for five days. Results: Five hundred and ninety three patients (97.2 %) were completely recovered from malaria within 3 to 5 days after receiving Primaquine tablets. Conclusion: In our opinion Primaquine should become the first line as antimalarial drug soon later for uncomplicated malaria, because of its high efficiency against infections with Plasmodiumfalciparum and P.vivax active stages.
Effect of Thyroid Dysfunctions on Complete Blood Count in Almatama Town-Sudan
(Middle East Research Journal of Microbiology and Biotechnology, 2024-01-04) Mosab Nouraldein Mohammed Hamad
Background: Thyroid hormones have a crucial role in the metabolism and proliferation of blood cells. Thyroid dysfunction causes different outcomes on blood cells such as anemia, erythrocytosis, leukopenia, thrombocytopenia, and in rare cases causes’ pancytopenia. It also alters RBC indices including MCV, MCH, MCHC, and RDW. Objectives: This is a cross-sectional descriptive study conducted in Almatama town during the period from September 2021 to January 2022, aimed to assess the effects of hypothyroidism and hyperthyroidism on blood cell count and RBC indices. Materials and Methods: Fifty patients with thyroid disease (24 hyperthyroidism, 26 hypothyroidism) and 20 healthy subjects served as controls. Whole venous blood samples were collected in EDTA anticoagulant container, mixed well, transferred to the laboratory according to standard procedures to avoid contamination, and then automatically counted for complete blood counts. Results: RBCs, HB, MCV, MCHC, and MCH, had statistically insignificant results in thyroid patients when compared with the control group (P. value 0.225,0.077,0.235,0.498,0.626) respectively. In hyperthyroid RBCs, HB, PCV, MCV, and MCH were statistically insignificant (P. value 0.388,0.951,0.123,0.575,0.148) respectively, and a statistically significant MCHC (P. value 0.0020). In hypothyroid HB, PCV, and MCH were, statistically significant (P. value 0.001,0.010,0.029) respectively, RBCs, MCV, and MCHC were, statistically insignificant (P. value 0.166,0.107,0.125) respectively. Conclusions: The hematological parameters were affected by thyroid disease, In case of patients with unknown hematological dysfunctions, must be evaluated for thyroid hormones. The follow-up of patients with thyroid disorders should have the complete blood count and patients diagnosed with anemia should be considered for thyroid conditions before iron treatment. Cases of anemia that resist therapy should be investigated for the case of thyroid dysfunction.
Efficacy of Pethidine in the Treatment of Postoperative Shivering on Elective Caesarean Section Patients at Wad Madani Maternity Teaching Hospital, Gezira State, Sudan
(جامعة الشيخ عبدالله البدري, 2022-05-24) Jamil A. Alshdadi; Mohammed K. Ahmed; Sonia A. Ahmed; Ghanem M. Mahjaf; Mosab Nouraldein Mohammed Hamad; Tarig Mohamed Ahmed Mohamed
Abstract: Shivering is one of the most common complications of neuraxial blockade. Some patients find shivering sensation worse than surgical pain post-operatively. Therefore, both prevention and treatment of established shivering should be regarded as clinically relevant interventions during the preoperative period. This prospective experimental study was conducted at Wad Madani Maternity Teaching Hospital and aimed to measure the efficacy of pethidine when used for the treatment of postoperative shivering following spinal anesthesia during the period from November 2018 to February 2019. The sample size included of 40Patients within the American Society of Anesthesia type two physical statuses;25 mg pethidine diluted in 5 ml Normal saline-injected intra veins. All patients were monitored for temperature, heart rate, blood pressure, and oxygen saturation, these parameters were recorded preoperative, and post 10 minutes of operative, then after 10 minutes of pethidine dose administration. Data were analyzed by using a statistical package for social sciences (SPSS). The statistical results showed that there was a significant relationship between hypothermia and the presence of shivering. 90% of cases resolved to shivering, whereas 10% did not resolve, just 2.5% had Nausea and Vomiting and no side effects on the Respiratory and cardiac Systems. Based on those results the study concluded that: a small dose of pethidine 25 mg intra veins is very effective in resolving postoperative shivering with minimum side effects in the gastrointestinal tract and Good Cardiopulmonary stability. The study recommended that: warming tools should be available for patients to prevent heat loss, close monitoring of Patient's temperature intraoperative and in the recovery room, and use of 25mg Pethidine in the Presence of shivering intraoperative or post-spinal anesthesia.
Evaluation of Complete Blood Count Changes in Patients Undergo Hemodialysis in Shendi Town, Sudan
(Middle East Research Journal of Microbiology and Biotechnology, 2024-01-04) Mosab Nouraldein Mohammed Hamad
Background: Chronic Renal failure is a major health problem and affects the economic and social status of patients. In Sudan, according to the ministry of health records, the prevalence of renal failure is increasing by approximately 70 to 140 new patients undergoing dialysis each year. This high frequency is thought to be due to epidemic malarial infection, which is well known to cause glomerulonephritis. Methods: This is a cross-sectional descriptive study conducted in Shendi town during the period from September 2021 to January 2022, and aimed to determine hematological parameters in hemodialysis patients. A total of venous blood samples were collected in EDTA anticoagulant containers then mix well and transfer to the laboratory, following standard procedures to prevent contamination, then count complete blood count automatically. Results: Statistical analysis by SPSS showed that the Mean of HB in pre and post-hemodialysis was(7.4g/dl and7.9 g/dl), the mean PCV in pre and post-hemodialysis was(22.7% and 25.8%), the mean of RBCs count in pre and post hemodialysis was(2.6x1012cell/l and 2.8x1012cell/l), the mean of WBCs count in pre and post hemodialysis was(5.4x109/L and 5.1x109/L), the mean of platelet count in pre and post hemodialysis was(152000cell/mm3 and 146000cell/mm3), the mean of the MCV in pre and post-hemodialysis was(86.7fl and 89.0fl), the mean of MCH in pre and post-hemodialysis was(28.3pg and 28.2pg) and the mean of MCHC pre and in post hemodialysis (32.8g/dl and 31.9g/dl). Conclusion: The study concluded that the hematological parameters in Shendi town in Hemodialysis patients cause an increase in RBCs, Hb, PCV, and lymphocyte count, no significant effect on PLTs, red cell indices not affected by hemodialysis and remain within normal range and women more affected than men as well as elder people.
Evaluation of Iron Profiles and Coagulation Profiles in Ischemic Heart Diseases Patients in Elmek Nimir Hospital, Sudan
(SAR Publiher, 2024-01-03) Mosab Nouraldein Mohammed Hamad
Background: Ischemic heart disease (IHD) is a constellation of diseases that includes stable angina, unstable angina, myocardial infarction, and sudden cardiac death. It belongs to the group of cardiovascular diseases and is the most common type among them. Iron is an essential trace element. It plays an important role in maintaining various cellular functions and enzymatic reactions. On the other hand, excessive intake of iron is known to be a risk factor for the progression of atherosclerosis. Abnormal iron deposition in the heart causes hemochromatosis and dilated cardiomyopathy, which leads to ischemic heart disease. Objective: This study aims to investigate the role of serum iron, serum ferritin, total iron-binding capacity (TIBC), PT, and PTT in ischemic heart disease (IHD) and their relationship with other risk factors for IHD. Methods: This is a prospective, case-control, cross-sectional analytical study conducted at Elmek Nimir University Hospital, Shendi City, to assess the iron profile and coagulation profile of patients with ischemic heart disease. The study included (30) patients diagnosed with ischemic heart disease and the study group was compared with the mean of the control group (20). Serum iron, ferritin, and TIBC were estimated using a spectrophotometer, and PT and PTT were estimated using manual methods. Data were collected using a structured personal questionnaire and the program (SPSS) version (11.5) was used for data analysis. Results: In this study, patients with ischemic heart disease were (40%) male and (60%) female. In this study, iron averaged (41.0) ug/dl (P. value 0.010), ferritin averaged (233.0) ug/dl (P. value 0.000), and TIBC averaged (44.0) μg/dl. Was shown. (P. value 0.000) compared to mean controls (27.0), (162.0), (56.0). A significant difference was found between the iron profile and his IHD. This study showed the mean PT, PTT for cases (13.4), (40.4) (P-value 0.024), (P. value 0.009) compared with the mean for controls (12.0), (35.1). A significant difference was found between the coagulation profile and IHD. Conclusions: This study concluded that serum levels of iron, ferritin, TIBC, PT, and PTT may be associated with Ischemic heart disease.
Evaluation of Iron Profiles and Coagulation Profiles in Ischemic Heart Diseases Patients in Elmer Nimr Hospital, Sudan
(جامعة الشيخ عبدالله البدري, 2023-04-27) Mosab Nouraldein Mohammed Hamad,
Abstract Back ground chemic heart disease (IHD) isa constellation of diseases that includes stableangina,unstableangina,myocardialinfarction,andsuddencardiacdeath.It belongs to the group of cardiovascular diseases and is the most common type among them. Iron is an essential trace element .it plays an important role in maintaining various cellular function and enzymatic reactions. On the other hand, excessive intake of iron is known to be a risk factor for the progression of atherosclerosis. Abnormal iron deposition in the heart causes hem chromatists and dilated cardiomyopathy, which leads to is chemic heart disease .Objectives :This study aims to investigate the role of serum iron ,serum ferritin ,total iron-binding capacity(TIBC), PT, and PTT in is chemic heart disease(IHD)and their relationship with other risk factors for IHD This is a prospective, case-control, cross-sectional analytical study conducted at Elmer Narmer University Hospital, Shendi City, to assess their on profile and coagulation profile of patients with is chemic heart disease. The study included (30) patients diagnosed with is chemic hear the diseases and the study group was compared with the mean of the control group (20). Serum iron ,ferritin ,and TIBC were estimated using a Spectro photo meter ,and PT and PTT were estimated using manual methods. Data were collected using a structured personal questionnaire and the program (SPSS) version(11.5)was used for data analysis In this study, patients with is chemic heart disease were (40%)male and (60%) female. In this study, iron averaged (41.0) ug/dl (Value 0.010), ferritin averaged (233.0) ug/dl (Value 0.000), and TIBC averaged (44.0) μg/dl. Was shown. (Value 0.000) compared to mean controls (27.0), (162.0), (56.0). A significance difference was found between their on profile and his IHD. This study showed the mean PT,PTT for cases (13.4), (40.4) (P-value 0.024), (P. value 0.009) compared with the mean for controls (12.0), (35.1). A significant difference was found between the coagulation profile and IHD Cardiovascular disease (CVD)isa type of disease that affects the heart ,blood vessels(arteries ,capillaries, veins),or both[1]. Cardiovascular diseases refers to all diseases that affect the cardiovascular system, primarily heart disease, cerebral and renal vascular disease, and peripheral arterial disease [2]. The causes of cardi vascular disease are varied ,but at her sclerosis /or hyper tension are the most common [3]. In addition, a variety of physiological and b biochemical changes alter cardiovascular function in association with aging, leading to an increased risk of subsequent cardiovascular disease, even in healthy a symptom at in individuals[4].Cardiovascular disease is leading cause of death.In2008, 30% (30%)of fall deaths worldwide were due to cardio vascular disease. Mortality from cardiovascular disease is also higher in low- and middle-income countries, as more than 80% of all cardiovascular deaths occur in these countries [5].It is also estimated that by 2030 more than 23 million people will die annually from cardio vascular disease [5,6]. The causes, diagnosis ,prevention ,control, and /or treatment of all forms of the cardiovascular disease continue to be an active area of biomedical research ,with hundreds of scientific studies published each week. I'm here. In 2013, coronary heart disease (CHD) was the leading cause of death worldwide, with (8.14)million deaths ( 16.8%) compared with (5.74)million deaths12%)in1990 [7] the risk of dying from(CAD) at a given age decreasedbetween1980and2010,especiallyindeveloped countries[8]The number of cases of (CAD) in a given age group alsodecreasedbetween1990and2010[9].In the United States in 2010, approximately (20%)of (ages 65+) had (CAD (CAD),while(7%)and(1.3%) (Ages 45–64) (CAD) of (18-45 years old) Now. (10) More Mentha women at alienage [10].The Sudan H house hold Survey(SHHS)reported a prevalence of heart disease (2.5%). Hypert tensive heart disease(HHD),rheumatic heart diseases(RHD), ischemic heart disease(IHD),and cardiomyopathy account for more than (80%) of(CVD) in Sudan [6]. Heart disease is the leading cause of morbidity and mortality yin Sudan. Hypertension (RHD), (IHD), and cardio myopathy account for the majority of four (CVD).Hyper tensions common and poorly controlled [11]. Most cardiovascular diseases can be prevented by addressing risk factors such as to because, unhealthy diet obesity ,physical inactivity, hypertension, diabetes, and elevated lipids. More than half of the heart disease deaths in 2009 were men. Coronary heart disease (CHD)is the most common heart disease causing more than (385,000) deaths each year[6]. Ischemic heartseases associated with progressive mechanical obstruction, dynamic obstruction, plaque inflammation, instability, and rupture, followed by super imposed thrombosis . Clinicians are employ in additional tools to aid clinical assessment and improve their ability to identify &quo that -risk "e; patients who are at risk for cardiovascular disease[12,13].Bio mark arrasene of the tools to better identify at-risk individuals ,diagnose medical conditions quickly and a cure lately ,and effectively diagnose and treat sick patients. Biomarkers can be measured in biological samples (as blood, urine ,or tissue tests), can be human records (blood pressure, electrocardiogram, or holder), or imaging tests (echocardiogram).Normally very small amounts of iron are present tin most body cells, plasma ,and other extracellular fluids ,under body strictly limits its iron supply so that every day (0.1%)of the body's microcontents lost. maintain. Mainly in desquamated cells [14]Iron `s high activity is a two- Edged word, and free iron ions in the body also participate in destructive chemistry ,primary catalyzing the formation of toxic free radicals .Iron play role in the process of at hero sclerosis by catalyzing the formation of free radical and also this contributes to reperfusion Damage .High serum ferric tin concentration was associated with increased risk of my dial infarction, independent of major cardiovascular risk factors. Abnormal deposition of iron in the heart cause phenom at sis and dilated cardiomyopathy and this causes or imaging tests (echocardiogram).Normally very small amounts of iron are present tin most body cells, plasma, and other extracellular fluids ,under body strictly limits its iron supply so that every day (0.1%)of the body's microcontents lost. maintain. Mainly in desquamated cells [14]Iron `s high activity is a two- Edged word, and free iron ions in the body also participate in destructive chemistry ,primary catalyzing the formation of toxic free radicals .Iron play role in the process of at hero sclerosis by catalyzing the formation of free radical and also this contributes to reperfusion Damage .High serum ferric tin concentration was associated with increased risk of my dial infarction, independent of major cardiovascular risk factors. Abnormal deposition of iron in the heart cause phenom at sis and dilated cardiomyopathy and this causes causing is chemic heart disease [1].Coagulation play roe in is chemic heart disease ,increase plasm a level so coagulation in are associated with an increased risk of my ocarina infarction The orthro in time alone is derived from measures of prothrombin in ratio{PR}and intermate on abnormalized ratio{INR] are essays evaluating the extrinsic pathway bayan dc ammonal way of coagulation. They are used to determine the clotting tendency of blood in homes of war farinose[2]. The role of blood clotting activation such as elevated circulating level of Amar cero fathom Bing enervation and fibro in peptide A in the occurrence of angina in I s chemic heart disease[3].Activated thromboplastin tin time issued to monitor the effects of the part non intrinsic pathways and detect defects in factors XII, XI, IX, VIII, and the common pathway .This study concluded that serum levels of iron ,ferret in ,TI, BC ,PT ,and PTT may be associated with is chemic heart disease.
Factors Influencing performance in Clerkship MCQs Examinations
(جامعة الشيخ عبدالله البدري, 2019) Mosab Nouraldein Mohammed Hamad; Yousif Mohammed ELhaj Mohammed Ahmmed; Mohammed Medani Eltayeb Abdullah
Multiple choice questions (MCQs) examinations are well established and widely used in a large number of medical schools(Haladyna, Downing et al. 2002). Multiple choice questions are considered to be the most objective, and valid tool for student assessment (Paxton 2000). Reasons of popularity of MCQs among medical teachers include their ability to test factual recall, interpretation of sets of data and problem solving. Also MCQs test a wide area of knowledge in short period of time and are of easy and objective scoring. Appropriately constructed MCQs result in objective testing that can measure knowledge, comprehension, application, and analysis (Collins 2006). Formats of MCQ are False/true, one best answer, one correct answer, extended matching and interpretative exercise. Strengths of MCQs is useful for outcomes where there are only few possible alternatives, less affected by reading ability, can be answered in reasonable time, easy to score, good concurrent and predictive validity, the face validity is satisfactory if the question is well structured, the content validity is high if questions address important area, reliable, discriminatory, reproducible, cost effective and high on the index of utility. Limitation of MCQs Difficult to write, knowing the false item provide no evidence that student know the correct one . no diagnostic information is provided from incorrect answers, score is influenced by guessing, validity are affected by construction, test low level knowledge-recall and score does not reflect the amount of student achievements. Recent research on multiple choice questions has identified deficiencies of inadequate content-equivalence and item-writer bias. Systematic methods of writing multiple choice questions are being advocated as effective responses (Cox, Irby et al. 2007).
Frequency of Red Blood Cells Sensitized with Allo-antibodies in cord blood in Atbara and Eldamer localities, Sudan
(جامعة الشيخ عبدالله البدري, 2022-06-22) Mosab Nouraldein Mohammed Hamad; Nusaiba Mubarak Sirelkhatim Khalafalla; Elharam Ibrahim Abd Allah; Zakaria Albadawi Alagmi; Ghanem Mohammed Mahjaf
Abstract: A direct antiglobulin test (DAT) is not routinely used in developing countries including Sudan. The direct antiglobulin test (DAT) is a screening test for antibodies present in an individual’s red cells and is used to diagnose hemolytic disease of the newborn (HDN). The study was to determine the prevalence of DAT among infants at Atbara and Eldamer. The study was designed as a descriptive, cross-sectional study carried out among neonates during January and February 2019 Atbara and Eldamer. ABO group and DAT were carried out among 100 samples of neonatal cord blood. Data were analyzed using SPSS version 22. A total of 100 neonates were recruited for the study. Among 100caces ABO incompatibility status was determined in 74 cases. The higher frequency was (O+, O+)(40%), the lower frequency was (AB+/AB+)(2%) while ABO incompatibility between neonates and mothers was found in 26 (26.0%) cases, The higher frequency of (A/O) incompatibility (15%), the lower frequency was (B+/A+),(AB+/A+)(1%) by the ABO group distribution at the Atbara & Eldamer localities. in this study positive DAT was detected in 2/100 (2.00%) cases (positive DAT was attributed to a typical antibody) two cases are the (O+/O+) group, These two neonates (O RhD positive) and the mothers (O RhD positive), The two cases of alloimmunization were mothers multipara without a history of past transfusions. The study concluded that sensitization with alloantibodies was found among neonatal blood which reflects the importance of detection of allo Abs among cord blood and mothers.
Hypothesis: Gastric Acidity as a Possible Cause of Antimalarial Failure in Sudan
(Middle East Research Journal of Microbiology and Biotechnology, 2023-12-26) Mosab Nouraldein Mohammed Hamad
Malaria is an endemic disease in Sudan and represent one of major health problems influencing the fragile economy of the country, as many protocols established there, but still malaria cases exaggerated, certainly after the current conflicts between army and the paramilitaries. Wars, poverty, and their social consequences increase stress among local population, which regarded as on of the main causes of acidity, besides malnutrition, wrong feeding behavior and opportunistic infections with certain bacteria such as H. pylori and some fungi like overgrowth of candida species may elevate the blood acidity. Unfortunately, acidity affect absorption of antimalarials, then we suggested that usage of antiacids should preceed ingestion of antimalarial tabs to enhance its absoption, in order to clear malaria parasite from blood. Luckily, antiacids releive acidity of microbial origin, which is attibuted to candidal overgrowth or H. pylori infection, and then as we mentioned above increase clearance of plasmodium. Patient history of recurrent gastric acidity, stool analysis, H. pylori test and blood PH are recommended to avoid treatment failure of malaria patient. Besides antimalarial misuse among our local population in Sudan we suggested that gastric acidity is the one of the main reasons of antimalrial protocols failure in Sudan, specifically after choloroquine resistance. We hypothesized that usage of antiacids prior to administration of antimalarial drug will promote the effectiveness of antimalarials
Isolation and Identification of Bacterial Contamination Water Supply in Shendi City-Sudan
(Middle East Research Journal of Microbiology and Biotechnology, 2024-01-04) Mosab Nouraldein Mohammed Hamad
Background: Microbial contamination of water persists to be a significant problem; the usual source is human and animal fecal matter that has contaminated the water systems. The presence of bacteria and pathogenic organisms is of great concern when considering the safety of drinking water, as pathogenic organisms can cause watery diarrhea, cholera, typhoid fever, and other illnesses. Objective: This is a prospective tap water examination study to find groundwater microbiological fecal contamination. Materials and Methods: Water samples for laboratory examination were collected from a different area of Shendi city, which were classified as Tap water. Each sample was a collection in a sterile container and then isolated and Confirmation by biochemical test. Results: Tap water samples were found to be contaminated with E. coli about 80 (63.6%) samples, an indicator of contamination with the fecal matter of animals and humans. It was the isolation of other Gram-negative enteric bacteria such as Salmonella and pseudomonas these were not scientific indicators of water contamination by animal and human fecal matter. Conclusions: Tap Water was contaminated with feces and posed a health risk to consumers of that water and was found to be contaminated with E.coli bacteria. Future studies are needed to understand the complicated issues concerning water quality in the city. Community-led sanitation and hygiene education and better water source protection are urgently required.
ocular parasitology
(جامعة الشيخ عبدالله البدري, 2018) Mosab Nouraldein Mohammed Hamad
Introduction: The human eye is an organ which reacts to light and pressure. As a sense organ, the mammalian eye allows vision. Human eyes help provide a three dimensional, moving image, normally colored in daylight. Rod and cone cells in the retina allow conscious light perception and vision including color differentiation and the perception of depth. The human eye can differentiate between about 10 million colors and is possibly capable of detecting a single photon. Similar to the eyes of other mammals, the human eye's non-image-forming photosensitive ganglion cells in the retina receive light signals which affect adjustment of the size of the pupil, regulation and suppression of the hormone melatonin and entrainment of the body clock. (1)
Patterns of Presentation and Management of Differentiated Thyroid Cancer at the National Cancer Institute - Central Sudan
(جامعة الشيخ عبدالله البدري, 2021-09-10) Ahmed Mahjoub Awad Ali; Mohamed Nasreldin Mohamed; Mohamed Soud Mohamed Saadeldien; Mohammed Ahmed Ibrahim Ahmed; Nahla Ahmed Mohammed Abdelrahman; Nassreldeen Khalid Abdelrahman Adam; Mosab Nouraldein Mohammed Hamad; ElhajIdris Tibin
Abstract: Background: Thyroid cancer is the second most common cause of mortality amongst endocrine malignancies, after ovarian cancer. Thyroid tumors that are differentiated account for around 95% of all thyroid malignancies. Thyroid cancer now outnumbers all other cancers in terms of occurrence. Objective: The study aimed to investigate the pattern of presentation and management of differentiated thyroid cancerat the National Cancer Institute in Wad Medani, Gezira State–Sudan. Methods: This is a retrospective descriptive hospital-based research that included all patients with differentiated thyroid carcinoma who presented to the National Cancer Institute Wad Medani between September 2016 and September 2020. The information is gathered using a standard structured data collection sheet and evaluated with SPSS for scientific class packaging for the social meaning of statistical packaging for social sciences version 24, USA. Results: Females 56 (76%) out of 74 patients with differentiated thyroid carcinoma at the National Cancer Institute Wad Medani had a male-to-female ratio of 1:3.2, and18 of them (24.3%) were in the 41-50 year age category. Sixty-nine (93.2%) of patients exhibited anterior neck swelling, whereas 15 (20.3%) reported shortness of breath. Sixty-six (89.2%) of patients had euthyroid status, and forty-nine (66.2%) had multinodular findings on ultrasonography, while the lateral compartment of lymph nodes was implicated in 8 (10.8 %) patients, the lateral and central compartments were engaged in 6 (8.1 %) patients, and the rest of the patients had no affected lymph nodes, 60 (81.1 %) had cold nodules on radioisotope scan, and 63 (85.1%) had cold nodules. Long-term goiter, which was reported in 20 of the research subjects, was the most prevalent risk factor (27 %).Papillary carcinoma is the most common histological form, accounting for 38.4% of all cases. Were 41(55%) with TNM stage-I. The scalp is the first site of metastases 6 (8.1%) in eighteen (24.3%) cases. The 38.4% of the patients had a total thyroidectomy, which was proceeded by radioactive iodine therapy in 47.4% of the cases. Conclusion: Early thyroid cancer identification is critical for effective management of differentiated thyroid carcinoma.
Prevalence of Anemia among Pregnant Ladies Attended to Alfadlab Hospital, River Nile State, Sudan
(جامعة الشيخ عبدالله البدري, 2022-10-10) Fania A Albadri; Mosab Nouraldein Mohammed Hamad; Ahmed Mohammed Babiker; Nousiba Elgasim; Abd elwahab Jah elnabi Jubara; Ammar Abdallah Hussein
Abstract: Background: Anemia represents a major health problem worldwide, and it becomes very complicated hematological disorder when occur in pregnant ladies. Method: 100 pregnant ladies included in a hospital based cross sectional study at Alfadlab hospital, River Nile State, hematological analyzer used to test hemoglobin for each participant. Result: 27 (27%) of the participated pregnant women was anemic, and malaria increase the severity of anemia among them. Conclusion: Anemia affected more than quarter (27%) of the participants .further studies recommended with large sample size.

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