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Item Toxoplasmosis among rich Sudanese females(جامعة الشيخ عبدالله البدري, 2018) Mosab Nouraldein Mohammed HamadBackground: toxoplasmosis is a disease that results from infection with the Toxoplasma gondii parasite, one of the world¶s most common parasites1. T. gondii has an environmental stage oocysts are shed in cat feces, sporulate, and disperse in the environment, where intermediate hosts get infected. Oocysts are an important source of infection for both animals and human. Objectives: The purpose of this study was to determine the prevalence of toxoplasmosis among selected group of rich Sudanese females. Materials and methods: A total of 45 rich volunteers females diagnosed serologically by latex agglutination method at parasitology laboratory, Faculty of Medical laboratory, Elrazi University, Sudan. Result: From a total of 45 rich volunteers¶ females diagnosed serologically by latex agglutination test, 33.3 % were seropositive and 67.7 were seronegative. Discussion: Toxoplasmosis is one of the most important diseases, which is more commonly diagnosed serologically. When we compare our study result with the results of previous studies we observed the lowest percentage of toxoplasmosis among rich Sudanese girls so toxoplasmosis is suspected to be reduced by improving the lifestyle of people. Conclusion: In summary we conclude that rich volunteer¶s girls is associated with low prevalence of toxoplasmosis, another studies is recommendItem schistosomiasis and bacterial urinary tract infections(جامعة الشيخ عبدالله البدري, 2018) Mosab Nouraldein Mohammed HamadAbstract Bacterial infections are often recurrent and important complications of the inactive stage of urinary schistosomasis The research was carried out to determine the frequency of bacterial urinary tract infection among schistosomasis school children In this study 120 urine samples were collected from school pupils in some villages of rural southern Shendi town, their average age between 5-16 years, and examined for the presence of S.haematobium eggs using centrifugation technique and for bacteriuria by routine bacteriological methods. A total of 120 school children was included in the study, 84 was suffering of schistosomasis and 36 uninfected. Out of 84 who had schistosomasis 37 (44.05%) showed significant bacteriuria, 47 (55.95%) had insignificant bacteriuria (p.value =0.001). The bacterial isolated including: klebsiella species, Escherichia coli, E.facailis, Salmonella species, Proteus species, and Pseudomonas species. Eshericha coli occurred more frequently 17 (45.95%) than the rest of the bacterial species isolated. The antimicrobial susceptibility test of isolates revealed varying patterns of susceptibilities by all isolates. This study clearly suggests that bacteriuria is schistosomiasis. a potent complication in the management of urinaryItem ocular parasitology(جامعة الشيخ عبدالله البدري, 2018) Mosab Nouraldein Mohammed HamadIntroduction: 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)Item 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 HamadAbstract- 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.Item 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 HamadBackground: 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.Item Vitamin D as a Possible Factor that Reduces COVID-19 Complications(جامعة الشيخ عبدالله البدري, 2020-10-30) Ayman Mohamed Alfadil Mohamed; Nizar Mahmoud Abdelrahman Mohammed; Mosab Nouraldein Mohammed HamadAbstract Corona Virus Disease 19 (COVID-19) remains a serious health problem worldwide cause by a novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS COV-2) which rapidly declared on 30-Jan-2020 as a global pandemic by WHO. Unfortunately, there is no effective treatment or vaccine available so far. The only preventive measure to break the spreading of the virus is by physical distancing, wearing masks, and lockdown of countries. All of the above mentioned measures implemented in European and African countries, despite that, the outbreak of the African countries has resulted in quite a few number of cases. Sever cases of COVID-19 is resulted from acute lung injury and cytokine storm. Vitamin D is well known to inhibit the pathological inflammatory immune response by suppressing the activation of Th1 cells and activation of T regulator cells, as a result of that, vitamin D could minimize the occurrence of the cytokine storm. African countries has a privilege of sunshine most of the year seasons that help synthesizing Vitamin D3 which could explain the low number COVID-19 cases compared to European countries.Item Staphylococcal cassette chromosome mec in the Staphylococcus aureus isolated from retail meat(جامعة الشيخ عبدالله البدري, 2022) Zeinab Torki Baghbaderan; , Amir Shakerian; Ebrahim Rahimi1,2Abstract Background: Methicillin-resistant Staphylococcus aureus (MRSA) strains are among the most emerging causes of hospital- and community-acquired infections. Retail meat is considered as one of its sources. The present survey was performed to assess the distribution of Staphylococcal cassette chromosome mec (SCCmec) amongst MRSA isolates of retail meat. Methods: A total of 28 MRSA isolates of retail meat samples were assessed to distribute the SCCmec type. MRSA. Isolates were confirmed using the biochemical tests and cefoxitin and oxacillin susceptibility tests. PCR was used to detect SCCmec types amongst the MRSA isolates. Results: A total of 7 different SCCmec types were detected in the MRSA bacteria isolated from retail meat samples. SCCmec type V (46.4%) had the highest distribution amongst examined MRSA isolates, while SCCmec type I, IVb, and IVc (7.1%) had the lowest. There were no positive results for the SCCmec type II. Statistically, a significant difference was obtained between the source of MRSA isolation and SCCmec distribution (P <0.05). Conclusion: As most isolates harboured SCCmec types IV and V, they originated from the community and called community associated MRSA (CA-MRSA). Thus, the role of retail meat as a source of CA-MRSA was determined in this survey.Item 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 HusseinAbstract: 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.Item 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 TibinAbstract: 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.Item 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 HamadAbstract: 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 HemorrhageItem 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 HamadAbstract: 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 hypoalbuminemiaItem The Prevalence and Major Risk Factors and Presentation Among Patients with Stroke in Atbara Teaching Hospital During the Period from February 2021 to April 2022(جامعة الشيخ عبدالله البدري, 2022-07-18) Tarig Mohammed Ahmed; Amna Abdalmaged; H. Amar; Fatima Abdalkareem Osman; Hind Tarig I. Yousif; Ghanem Mohammed Mahjaf; Mosab Nouraldein Mohammed HamadAbstract: Background: CVA is the loss of brain function due to a disturbance in the blood supply of the brain. This disturbance is due to either ischemia or hemorrhage. Aim: To study the major risk factors & presentation among patients with stroke in Atbara teaching hospital. Methodology: Cross-sectional descriptive hospital based study was conducted in Atbara teaching Hospital from February 2021 to April 2022. The data was collected by interviewing the patients through a closed-ended questionnaire and analyzed by using the statistical computerized program SPSS. Results: In our study, we found that 86.2%of study group their age group was more than 51years and most of them are males, 73.1% of them had a hemiplegic weakness, 60.8% of them had a transient ischemic stroke,90% had an ischemic stroke, 66.9% with one attack of stroke,77.7% of them have a chronic illness,53.1%have diabetes,63.8% have hypertension,28.5% of them have ischemic heart disease,23.8%have atrial fibrillation,11.5% have the valvular disease, 35.4 % of them are smokers and 6.9% are drinking alcohol. Conclusion: The study concluded that stroke increased with age above 51 years old and most commonly in males. The most common risk factor is HTN, DM, and heart disease. The common risk bad habit in strokes patients are smoking.Item 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 MahjafAbstract: 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.Item 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 HamadItem 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 MohamedAbstract: 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.Item The Effect of Early Mobilization on Back Pain among Post Diagnostic Coronary Angiography Patients at Ahmed Gasim Cardiac and Renal Transplantation Hospital, Sudan(جامعة الشيخ عبدالله البدري, 2023-03-27) Nadia Ahmed Mohammed Hamad; Eman. Z. E. Yassin; Amal Mohammed Hamid; Manal Abd Alrahman; Fania. A. Abdari; ,Khadija Abdalhakam Taifour Mohamed; ,Ghanem Mohammed Mahjaf; Mosab Nouraldein Mohammed HamadAbstract: Coronary catheterization is a minimally invasive procedure to access the coronary circulation and blood- filled chambers of the heart using a catheter to recognize occlusion, stenosis, and thrombosis. This procedure is commonly performed through the femoral artery, which may induce possible complications such as bleeding or hematoma. Restricting patient movement was adopted to avoid these complications. The patient has to lie in bed in a supine position for at least 6 hours after angiography. This is an experimental case-control study, conducted to evaluate the effect of early mobilization on back pain. A sample of 300 adult patients was selected by a random sample technique. They were randomly allocated to 100 patients in the experimental group and 200 patients in the control group. The study was conducted from March 2017 to March 2019 at Ahmed Gasim Cardiac Surgery and Renal Transplantation Hospital in Khartoum State, Sudan. The experimental group was mobilized early after 4 hours and the control group had routine bed rest for 6 hours post-sheath removal. Both groups received the usual care. A structured questionnaire and checklist were used to collect data. Data were analyzed by using Statistical Packages for Social Sciences (SPSS).The results revealed that the two groups feel pain varying between no pain and mild (85%) in the cases and in the controls (89.0%) from one hour up to four hours but significant back pain increased clearly at five hours and six hours for the controls group (5th hours severe (6%) very severe (0.5%). P. value 0.000 significant and 6th hours severe (27.5%) very severe (6%). This study concluded that back pain reduction was statistically significant among the experimental group compared to the control group.Item Factors Influencing performance in Clerkship MCQs Examinations(جامعة الشيخ عبدالله البدري, 2019) Mosab Nouraldein Mohammed Hamad; Yousif Mohammed ELhaj Mohammed Ahmmed; Mohammed Medani Eltayeb AbdullahMultiple 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).Item 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.