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Sudan's healthcare system has been severely disrupted by the ongoing humanitarian crisis, limiting access to essential services and medications. Understanding health-seeking behaviors during such disruptions is critical to informing culturally appropriate public health responses, particularly regarding traditional medicine use. This study aimed to assessPatterns of Herbal Medicine Utilization for Hypertension During the Sudanese Crisis of 2025. This cross-sectional study was conducted from February to June 2025 among adults with physician-diagnosed hypertension who were prescribed antihypertensive medication at diagnosis. Data were collected using a structured validated questionnaire administered face-to-face using Kobo Toolbox. Convenience sampling yielded 749 valid responses. Data were analyzed using SPSS v27, with statistical significance set at p < 0.05. The mean age was(56.8 ± 11.9) years; (54.1%) were female, (29.8%) were displaced and (50.5%) reported difficulty accessing antihypertensive medications. Herbal medicine use was reported by (91.2%); 65.2% used herbs before and during the crisis, and (19.8%) initiated use after the crisis began. Concurrent use of herb-drug use was reported by (71.7%), while adverse effects were uncommon(5.7%), and mostly mild. Lower income and rural residence were significantly associated with herbal use (p < 0.05). Herbal medicine use was wide spread among hypertensive Sudanese adults during the crisis, largely driven by affordability, accessibility challenges, and cultural familiarity. Given the high rate of concurrent use, public health messaging and clinician training on herb-drug safety should be prioritized.

Methotrexate (MTX) is a commonly prescribed drug with both chemotherapeutic and immunosuppressive applications. However, when administered in high doses (HDMTX [greater than or equal to] 500 mg/m.sup.2), it can lead to serious side effects, particularly nephrotoxicity and hepatotoxicity. Although 48-h MTX levels monitoring is fundamental for the evaluation of the risk of these toxicities, the relationship between MTX level and the actual clinical outcomes is not yet fully addressed. This study aims to evaluate the predictors of 48-h serum MTX levels and the toxicity profile associated with patients receiving HDMTX for management of cancer, with a particular focus on nephrotoxicity, hepatotoxicity, length of hospital stay (LOS), antimicrobial use, and 30-day mortality. A retrospective cohort study was conducted at the National Cancer Institute, Cairo University. Patients receiving HDMTX as part of their cancer treatment in the period from January 2022 to December 2024 were included. Data collection included patient demographics, administered MTX doses, 48-h serum MTX levels, medical and medication history, antimicrobials used, and recorded adverse effects. The outcome of the study encompassed the identification of predictors for 48-h MTX levels and their association with acute kidney injury (AKI), ICU admission, and LOS. In addition to the associations with hepatotoxicity, antimicrobial usage, and mortality. Statistical analysis was performed using SPSS version 26.0. Among 143 patients, elevated 48-h MTX levels ([greater than or equal to] 1.28 mol/L) were associated with pleural effusion (P-value 0.038), patients diagnosed with lymphoma (P-value 0.05), and increased antimicrobial use (P-value < 0.05). A significant association was found between HDMTX and the use of carbapenems, vancomycin and fluoroquinolones (P-value < 0.05). Non-significant relation was found between HDMTX and AKI as well as LOS. Hepatotoxicity was significantly more common in patients with osteosarcoma rather than hematological malignancies, while LOS was shorter in osteosarcoma cases compared to hematological malignancies. The serum levels of 48-h MTX are vital metrics of toxicity, as they determine the duration of hospitalization, the number of antimicrobials used, and the mortality rate. Thus, it is crucial to monitor these levels to reduce the complications associated with HDMTX usage.

Background Since the outbreak of armed conflict in Sudan on April 13, 2023, 13 million have been displaced, with young people bearing a significant share of the psychological burden. Despite growing awareness, the mental health impact of this crisis remains underexplored, especially among internally displaced persons (IDPs) and refugees aged 15 to 35. Methods This cross-sectional study assessed the prevalence and associated factors of depression, anxiety, and post-traumatic stress disorder (PTSD) among the displaced Sudanese youth, using validated screening tools (PHQ-9, GAD-7, and PC-PTSD-5). Participants were reached via an online questionnaire between September 2024 and January 2025. Multivariate logistic regression was conducted to identify key predictors for each mental health condition. Results Depression and anxiety were widespread, affecting over half the respondents, while PTSD symptoms were present in 19%. Financial loss, bereavement, job loss, and disruption of education were significantly associated with both depression and anxiety. PTSD was more likely among individuals displaced for over two years, those who experienced personal loss, and those whose education was interrupted. Females were disproportionately affected across all mental health outcomes. Conclusion The mental health toll of the ongoing conflict in Sudan is severe among displaced youth, with a high prevalence of depression and anxiety driven by financial insecurity, loss, and disrupted life trajectories. These findings underscore the urgent need for integrated mental health services within humanitarian responses. Addressing trauma through community-based interventions and psychosocial support is critical to prevent long-term harm.

Background Colorectal cancer (CRC) is one of the most common malignancies worldwide, with increasing evidence linking metabolic dysregulation, such as insulin resistance and chronic inflammation, to its development and progression. A potential useful predictor of CRC risk is the triglyceride-glucose (TyG) index, a marker for insulin resistance that is determined using fasting triglyceride and glucose levels. The purpose of this systematic review was to assess the relationship between the TyG index and CRC and ascertain whether the TyG index is associated with the development and outcomes of CRC. Methods A systematic review and meta-analysis was reported in accordance with the PRISMA guidelines. Comprehensive searches of PubMed, Web of Science, Scopus, and World Health Organization Virtual Health Library were conducted in 24th March 2025 to find studies assessing the relationship between the TyG index and CRC. Results of association between TyG index and CRC were summarized and a meta-analysis was done to calculate pooled hazard ratio (HR) with 95% confidence interval (CI). Results A total of eight studies were included in the systematic review, of which five met the criteria for inclusion in the quantitative synthesis. The pooled analysis showed that the hazard of developing CRC was significantly greater for those with a higher TyG index (HR = 1.18; 95% CI: 1.12–1.25; P  <.001). In addition, meta-analysis indicated that hazard of developing CRC significantly increased for each one-unit increase in the TyG index (HR = 1.28, 95% CI: 1.18 to 1.39, P  <.001). Conclusion Higher TyG index level is substantially linked to an elevated hazard of developing CRC. Therefore, the TyG index can be a useful tool for CRC risk identification. Standardizing cut-off values and researching clinical applicability in various populations should be the main goals of future research. Due to the limitations posed by the small number of studies, further prospective studies are needed to generate more robust and generalizable evidence.

The risk factors, disease characteristics, severity, and mortality of COVID-19 are unclear, particularly in Egypt. The objective was to analyze the patients' characteristics, hematological, biochemical, and chest imaging findings among the cohort of patients with COVID-19 in Egypt and also to shed light on the predictors of COVID-19 severity. A retrospective study was conducted on 66 patients with COVID-19 in Egypt. Medical history, imaging data (CT chest findings), and measured hematological and biochemical parameters at diagnosis were recorded in the form of complete blood counts and differential counts; CRP, ESR, serum ferritin, creatinine, and liver function tests . Results of real-time reverse transcription-polymerase chain reaction (rRT-PCR) for detection of SARS-CoV-2 RNA at diagnosis and during follow up of these patients were also recorded. The study included 36 patients with mild to moderate COVID-19 and 30 patients with severe/critical infection. There was a significant older age among severe (62.6 years old ±10.1SD) than mild to moderate infection (55.5 ± 10.1) ( ˂0.05). Fever, dry cough, dyspnea, and sore throat malaise were highly frequent among COVID-19 patients, while headache and diarrhea were the least frequently occurring manifestations. All included cases (30 patients, 100%) with severe COVID-19 showed crazy-paving appearance (in the form of reticular and/or interlobular septal thickening) with or without GGO. There were significantly lower mean values of WBCs, lymphocytic count, total protein, and albumin among the severely infected than those who had mild to moderate COVID-19 infection, ˂0.05 for all. Additionally, there were significantly higher mean values of CRP, ESR, ferritin, ALT, and AST among patients with severe/critical COVID-19 when compared with those having mild to moderate COVID-19, ˂0.05 for all. Among the studied demographic, clinical, hematological, biochemical, and imaging data, dyspnea, diabetes mellitus, lymphopenia, raised CRP, ESR, ferritin, ALT, AST, low albumin, and presence of CT chest findings could be considered as predictors for COVID-19 severity using binary logistic regression analysis.

Introduction Surgical site infections (SSI) represent a significant burden on patients and healthcare systems particularly in low-income countries with limited resources. This study aimed to assess the knowledge and counselling practices of medical personnel regarding the prevention of SSI in Sudan. Methods A cross-sectional hospital-based study was conducted. from June to December 2024. The target population included medical personnel involved in the surgical care in Sudan (surgeons, medical officers, house officers, final year medical students, operating room nurses, and ward nurses). Personnel not directly involved in surgical care were excluded. A structured, self-administered questionnaire was used to assess participants’ knowledge of SSI signs/symptoms, risk factors, and preventive techniques, as well as their counselling practices and perceived challenges to implementing SSI prevention strategies. Results The study included 403 participants. The majority (72%) correctly identified hand hygiene as a crucial preventive practice. However, a significant proportion (62.5%) incorrectly believed that routine preoperative shaving is recommended, indicating a common misconception. While (70.2%) correctly recognized antibiotic prophylaxis as important for reducing bacterial load, knowledge regarding its appropriate duration was variable. Only (37.2%) reported always providing preoperative counselling. Key challenges identified included limited resources, lack of updated guidelines and inadequate training. Conclusion Despite adequate awareness of certain preventive strategies, significant gaps in knowledge and inconsistent counselling practices persist. Education and training, the provision of up-to-date guidelines and ensuring resources availability are crucial interventions to reduce SSIs rates and improve surgical outcomes in Sudan.

Background The use of IOUS is increasingly common in recent neurosurgical practice. IOUS has become very valuable in neurosurgery. It plays a key role in the localization of space-occupying lesion location and decreasing operation time and hence improves both surgical efficiency and safety. Ultrasound is very useful in the determination of the lesion location, its most superficial portion, and in differentiation between solid tumors and cystic components. Results Intraoperative ultrasonography has a significant edge over the other intraoperative aids for image guidance in brain surgery, especially in terms of independence, cost, and adaptability to multiple different clinical scenarios. Ultrasound-based neuro-navigation is an easy-to-use, fast, and safe technique of real-time imaging for various neurosurgical procedures. Conclusion We conclude that ultrasound-based neuro-navigation is an easy-to-use, fast, and safe technique of real-time imaging for various neurosurgical procedures.

Background The ongoing conflict in Sudan has severely disrupted dental service delivery, highlighting the urgent need for alternative communication between patients and dental professionals. In this context, tele-dentistry has emerged as a critical, yet underexplored, solution for sustaining oral healthcare delivery. This study aimed to assess the acceptance and readiness for tele-dentistry among dental professionals in Sudan. Methods A cross-sectional study was conducted among 497 Sudanese dental professionals using a self-administered questionnaire based on the Tele-dentistry Acceptance Survey– Dentist Version (TAS-D). Data were analysed using R statistical software (version 4.3.2). Descriptive statistics were used to summarize participant characteristics. Bivariate analyses were conducted using the Wilcoxon rank-sum and Pearson’s Chi-square tests. Multivariable logistic regression was performed to identify predictors of acceptance of tele-dentistry. Results Overall, 59.8% ( n  = 297) of respondents reported a favourable attitude toward the future use of tele-dentistry. Acceptance of tele-dentistry use was significantly associated with academic qualification and work setting. Denttal professionals with an MSc degree had higher odds of acceptance compared to those with a BDS (OR = 3.00, 95% CI: 1.39–7.10, p  = 0.007). Working in an academic setting also increased the likelihood of acceptance (OR = 1.74, 95% CI: 1.18–2.59, p  = 0.005). Conversely, specialists were less likely to accept tele-dentistry than general practitioners (OR = 0.38, 95% CI: 0.15–0.90, p  = 0.033). Stratified analysis indicated that academic qualification and work setting remained significant predictors only among general practitioners. Conclusions A significant proportion of Sudanese dental professionals favour the use of tele -dentistry in the future, particularly those with postgraduate qualifications and those working in academic settings. These findings provide important insights to guide the development of tele-dentistry policies and capacity-building initiatives in Sudan.

Hepatic encephalopathy (HE) is a main manifestation of acute decompensation in liver cirrhosis. Recently, systemic inflammation was proposed as a key mechanism in the development of acute kidney injury (AKI) in cirrhotic patients. The urine albumin creatinine ratio (UACR) is considered a marker of systemic inflammation in a variety of clinical settings. Here, we aimed to evaluate the role of the urine albumin creatinine ratio in the early prediction of AKI in HE. Sixty-seven consecutive patients presented with cirrhotic HE, and 59 age- and sex-matched cirrhotic patients with no history of HE served as controls. HE was defined and graded by the West Haven criteria. The severity of liver cirrhosis was evaluated by the Child-Turcotte-Pugh (CTP) score, and model for end-stage liver disease (MELD) score. The incidence of AKI that developed during hospital admission and the in-hospital mortality rate was estimated among HE patients. In addition, predictors of AKI were analyzed. The mean age of HE patients was 58.09±12.26 years; 36 (53.7%) were males, and 31 (46.3%) were females. Among HE patients, 16 (23.9%) developed AKI during hospital admission. The in-hospital mortality rate among HE patients was 22 (32.8%), the in-hospital mortality among HE-AKI patients was 81.3% (n=13/16), and UACR levels > 91.5 mg/g identified HE-AKI with 81.25% sensitivity (AUC = 0.85, P [less than or equal to] 0.001).

The use of bio-stimulants (BSs) has become an important policy in managing many stressed crop plants through the regulation of the balance of phytohormones, osmo-protectors (OPs), antioxidant systems, and gene expression, all of which reflect plant growth and productivity. Garlic + onion extract (GOE) at a concentration of 2.0–3.0% and diluted bee honey solution (BHs) at a concentration of 1.0–1.5% were applied exogenously to squash (Cucurbita pepo) plants subjected to cadmium (Cd) + lead (Pb) stress (0.3 mM CdCl2 + 0.3 mM PbCl2). The objective was to determine the effects of these treatments on growth characteristics, organic metabolites/biomolecules, and mineral nutrients. Cd + Pb stress significantly increased electrolyte leakage (EL, 103%) and malondialdehyde (MDA, 90%) because of an increase in hydrogen peroxide (H2O2, 145%) and superoxide (O2•−, 152%) levels, and contents of abscisic acid (ABA, 164%), Cd (674–711%), and Pb (754–805%). Consequently, marked increases in the contents of OPs and non-enzymatic antioxidants (28–133%), activities of antioxidant enzymes (48–80%), and expressions of enzyme genes (60–84%) were observed. The administration of Cd + Pb treatment reduced plant growth and development parameters (25–59%), yield components (61–86%), photosynthetic components (27–67%), leaf proportional water content (26%), indole-3-acetic acid (IAA, 44%), gibberellic acid (GA3, 56%), and cyto-kinin (CKs, 49%) contents. Nonetheless, the administration of GOE, BHs, and GOE + BHs attenuated the adverse impacts of Cd + Pb stress. The best treatment was GOE + BHs which significantly decreased EL (52%) and MDA (49%) because of a reduction of O2•– (61%), H2O2 (60%), ABA (63%), Cd (89–91%), and Pb (89–91%) levels. This positive outcome was linked to an increase in the OPs’ (22–46%) and non-enzymatic antioxidant (27–46%) levels, activities of enzymes (26–44%), and enzyme gene expressions (35–40%), all of which contributed to the promoted relative water content (RWC, 37%), pigment contents (47–194%), hormonal levels (82–132%), growth traits (31–149%), yield components (154–626%), and fruit quality traits (31–92%). From these results, it can be concluded that treatment of GOE + BHs is recommended as a foliar application to reduce the adverse effects of Cd + Pb stress treatment in squash.