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BackgroundAtherosclerotic cardiovascular disease contributes substantially to morbidity and mortality worldwide. High-sensitivity cardiac troponin T (hs-cTnT) has become an essential tool in the initial management of acute myocardial infarction. Several, but not all studies, have demonstrated worse clinical outcomes with higher troponin levels in non-ST-elevation myocardial infarction (NSTEMI). However, outcomes associated with peak troponin levels following ST-elevation myocardial infarction (STEMI) have not been well established.PurposeTo determine the prognostic value of elevated hs-cTnT in the prediction of all-cause mortality and left ventricular ejection fraction (LVEF) in STEMI.MethodsSingle-centre retrospective observational study was conducted of all patients with STEMI between January 2015 and December 2017. False activations of the catheterisation laboratory were excluded. Demographics and clinical data were obtained through electronic patient records. Relationship between peak hs-cTnT and all-cause mortality at 30 days and 1 year, and LVEF was examined. Standard Bayesian statistics were employed for analysis.Results568 patients presented with STEMI during this period (186 in 2015, 194 in 2016 and 188 in 2017). Baseline characteristics are shown in table 1. Mean age was 63.6 years (SD 12.0) and 76.4% were male. Culprit vessels included: 220 (38.7%) Left anterior descending (LAD), 227 (40.0%) Right coronary artery, 95 (16.7%) Circumflex, 7 (1.2%) Left main stem, 1 (0.2%) Ramus and 18 (3.2%) multi-vessel or undetermined culprit. 535 (94.2%) underwent primary percutaneous coronary intervention, 12 (2.1%) urgent coronary artery bypass and 21 (3.7%) were treated medically. Mean peak hs-cTnT was 5124 ng/L for the cohort (range 20 – 57875 ng/L) (reference range <14 ng/L). Peak hs-cTnT measured at a median of 1 day from admission. Mean creatinine was 95.6 μmol/L. All-cause 30-day mortality rate was 6.2% and all-cause 1-year mortality rate was 8.8%. Mean peak hs-cTnT levels were significantly higher in those who died within 30 days compared with those who survived (12238 ng/L vs. 4657 ng/L respectively, p<0.001). Peak hs-cTnT levels were also significantly higher in those who died within 1 year compared with those who survived (10319 ng/L vs. 4622 ng/L respectively, p<0.001). One-way ANOVA exhibited significant differences in peak troponin between culprit vessels. LAD was associated with the highest hs-cTnT and was the most common culprit in those who died at 1 year. An inverse relationship was demonstrated between peak hs-cTnT and LVEF (Pearson’s R=0.379, p<0.00001; figure 1).Abstract 14 Table 1Baseline characteristics among STEMI patients and association with 1-year mortality (N=568) Baseline characteristics among STEMI patients and association with 1-year mortality (N=568)Abstract 14 Figure 1Peak troponin has a moderate relationship with left ventricular ejection fraction pearson’s correlation, r=−0.379, p<0.01 Peak troponin has a moderate relationship with left ventricular ejection fraction pearson’s correlation, r=−0.379, p<0.01ConclusionIn STEMI, those who died at 30 days and 1 year had significantly higher peak troponin levels than those who survived. Peak troponin is also inversely proportional to LVEF with higher troponins associated with lower LVEF. While the cost-effectiveness of performing routine troponins in STEMI is arguable, there may be a rationale for performing a single troponin sample at 24 hours post admission as a predictor of mortality and LVEF.Data represent the number (percentage) of [patients or median [interquartile range]. Mann-Whitney U test was used for comparisons of continuous variables; Fishers’s exact test was used for categorical variables.

Incomplete allergy documentation is a major contributor to medication errors and adverse drug events. At Atbara Teaching Hospital, allergy information was inconsistently recorded, with no standardized format or visible alert system. This audit aimed to improve the completeness and accessibility of allergy documentation through the introduction of a structured sticker and brief staff training. A two-cycle clinical audit was conducted in the Department of Internal Medicine at Atbara Teaching Hospital, Sudan, between August and October 2025. The first cycle reviewed 50 inpatient records to establish baseline compliance with international documentation standards. Following this, a standardized \"Allergy Documentation Sticker\" was designed and implemented, accompanied by short educational sessions for staff. The second cycle reviewed another 50 records post intervention. Data were analyzed using descriptive statistics and chi-square tests for significance. Baseline compliance with allergy documentation standards was poor. Fields such as allergen, reaction type, and severity were absent in all records (0/50, 0%). After introducing the sticker, compliance improved significantly to 50/50 (100%) for these parameters (p < 0.001). Documentation of \"Any Known Allergy?\" increased from 25/50 (50%) to 50/50 (100%) (p < 0.001), while doctor name and signature improved from 0/50 (0%) to 39/50 (78%) (p < 0.001). Minor improvements were also observed in demographic details, such as \"unit\" (38/50 (76%) → 45/50 (90%)). Overall, statistically significant gains were recorded across most fields, reflecting enhanced accuracy, accountability, and visibility of allergy records. Introducing a structured allergy documentation sticker significantly improved the quality and completeness of allergy recording in a paper-based hospital setting. The intervention was low-cost, sustainable, and adaptable, aligning with global patient safety priorities. Regular audits, continued education, and progressive digital integration are recommended to sustain these improvements.

Background Needle-stick injuries (NSIs) remain a major occupational hazard for healthcare workers, exposing them to blood-borne infections. Globally recognized occupational health standards emphasize structured training, safe sharps handling practices, and timely access to post-exposure prophylaxis (PEP). This audit evaluated staff knowledge and awareness of NSI prevention and management in a Sudanese teaching hospital, aiming to identify gaps and assess the impact of targeted interventions. Methods A two-cycle clinical audit was conducted over twelve months (September 2024-August 2025) at Bashair University Hospital. A structured, self-administered questionnaire was distributed to doctors, nurses, and laboratory technicians in both cycles (n = 90 per cycle). The tool assessed knowledge of NSI risk pathogens, immediate first-aid response, PEP initiation, sharps disposal practices, vaccination awareness, and reporting procedures. Interventions included structured teaching sessions, posters, departmental reinforcement, and distribution of guideline summaries. Data were analyzed descriptively and compared between cycles. Results Knowledge of HBV as the most common pathogen improved substantially among doctors (15.8%→81.2%), nurses (15.8%→100%), and technicians (65%→100%). Awareness of immediate wound washing also improved, reaching 100% among nurses and technicians. Understanding of PEP as medication increased markedly (doctors: 52.6%→93.8%; nurses: 52.6%→100%; technicians: 25%→100%). However, awareness of formal reporting systems declined sharply among doctors (89.5%→12.5%) and technicians (50%→5%). Participation in refresher training fell across groups, while perceived training adequacy showed only partial improvement. Conclusion Targeted interventions improved healthcare workers' knowledge of NSI prevention and management; however, persistent gaps in training sustainability and reporting culture indicate that these gains may not be maintained without continued institutional support. Sustained improvement requires structured refresher programs, robust reporting systems, and administrative commitment to embedding sharps safety into routine practice.

Background Long-term success of implant restoration depends on many factors one of them is the sufficient implant stability which is lowered in compromised bone density sites such as the maxilla as it is categorized as type III & IV bone, so searching for a new innovation and updates in implant material and features is very mandatory. So, the aim of this study was to compare between two implant materials (roxolid and traditional titanium) on the primary and secondary stability of implant retained maxillary overdenture. Methods Eighteen completely edentulous patients were selected. All patients received maxillary implant-retained overdentures and lower complete dentures; patients were divided equally into two groups according to the type of implant materials. Group A received a total number of 36 implants made of roxolid material and Group B received a total number of 36 implants made of traditional titanium alloys. Implant stability was assessed using ostell device, the primary implant stability was measured at the day of implant installation however, secondary implant stability was measured after six weeks of implant placement. Paired t-test was used to compare between primary and secondary stability in the same group and an independent t-test was used to compare between the two groups with a significant level < 0.05. Results Independent t-test revealed a significant difference between the two groups with p -value = 0.0141 regarding primary stability and p -value < 0.001 regarding secondary stability, as roxolid implant group was statistically higher stability than titanium group in both. Paired t- test showed a statistically significant difference in roxolid implant group with p -value = 0.0122 however, there was non-statistically significant difference in titanium group with p -value = 0.636. Mann Whitney test showed a significant difference between the two groups regarding amount of change in stability with p value = 0.191. roxolid implant group showed a higher amount of change in stability than the titanium implant group. Conclusion Within the limitation of this study, it could be concluded that: Roxolid implants showed promising results regarding primary and secondary stability compared to conventional Titanium implants and can be a better alternative in implant retained maxillary overdentures. Trial registration Retrospectively NCT06334770 at 26–3-2024.

Vitamin D plays a significant role in the function of the immune system and it influences many dermatological diseases such as psoriasis and atopic dermatitis. The prevalence of vitamin D deficiency is growing globally, with around 30-50% of people are known to have low levels of vitamin D. Acne vulgaris is a common inflammatory disorder of the pilosebaceous unit. Studies about the role of vitamin D in the pathogenesis of acne vulgaris have shown conflicting and nonconclusive results. Thus, the precise purpose of vitamin D has not yet been established. First, to evaluate serum levels of vitamin D through a representative sample of patients with acne vulgaris and compare it with matched healthy controls. Second, to investigate if there is a relation between serum vitamin D level and the severity of acne vulgaris. This cross-sectional study included 68 patients with acne vulgaris and 50 matched healthy controls. Serum 25-hydroxyvitamin D [25 (OH) D] levels were measured for both patients and healthy controls. The study yielded lower levels of serum 25-hydroxyvitamin D in patients with acne vulgaris than its level in healthy controls. This is statistically significant with P-value = 0.003. Regarding age, gender, and sun exposure, there is no significant variation in serum 25-hydroxyvitamin D level. Also, no significant difference between the severity of acne and serum 25-hydroxyvitamin D levels. This study has shown clearly that vitamin D deficiency is more frequent in patients with acne with P-value = 0.003. However, no significant association between the serum level of 25-hydroxyvitamin D [25 (OH) D] and the severity of acne vulgaris. Further clinical trials on a larger scale are needed to address the importance of vitamin D in acne vulgaris. Specifically, determining whether treatment of acne with both topical vitamin D analogs and vitamin D supplementation is of significant effect.

Background Diabetic cardiomyopathy (DCM) is a complex condition linked to diabetes, characterized by cardiac and vascular dysfunction, frequently concomitant with heart failure with preserved ejection fraction. The extracellular matrix glycoprotein Tenascin-C (TNC) has been found to be upregulated under diabetic conditions. However, the potential contributory role of TNC in the progression of DCM remains largely unclear. This study was designed to elucidate the role of TNC in the pathogenesis of DCM. Methods Diabetes was induced in adult male wild-type (WT) and TNC knockout (TNC-KO) mice, through the administration of streptozotocin (50 mg/kg) for five consecutive days. At 18 weeks cardiac and aortic vascular function was evaluated using echocardiography and wire myography. Myocardium and plasma samples were collected for biochemical, histological, and molecular analyses. Cardiomyocytes and cardiac fibroblasts were used to investigate the impact of diabetes on TNC expression, inflammation, myocardial stiffness and function. Additionally, transcriptomic analysis of cardiac tissue by RNA-sequencing was conducted. Plasma TNC levels were assessed by enzyme-linked immunosorbent assay in cohorts of heart failure patients and type 2 diabetes mellitus. Results TNC-KO diabetic mice showed preserved left ventricular systolic and diastolic function, significantly reduced cardiac fibrosis and mitigated endothelial dysfunction compared to WT diabetic animals. Compared with cardiomyocytes of diabetic WT animals, cardiomyocytes of TNC-KO mice developed less stiffness (Fpassive). Additionally, exposing mouse cardiomyocytes and human cardiac fibroblasts to high glucose stress (30 mM) led to a significant increase in TNC expression. Conversely, recombinant human TNC promoted pro-inflammatory and oxidative stress markers in cardiomyocytes. The role of TNC in fibrosis and DCM was found to involve pathways related to p53 signaling and Serpin1k, Ccn1, Cpt1a, and Slc27a1, as identified by RNA sequencing analysis. Additionally, plasma TNC levels were significantly elevated in patients with heart failure, irrespective of diabetes status, compared to healthy individuals. Conclusions Our findings indicate that in diabetes, TNC contributes to cardiac contractile dysfunction, myocardial fibrosis, oxidative stress, inflammation, and metabolic disturbances in diabetic mouse heart. These results implicate the potential of TNC inhibition as a novel therapeutic approach for treating DCM. Graphical abstract

Background The current trial evaluated the midfacial gingival margin changes, volumetric, radiographic and clinical alterations 1-year following immediate implant placement with customized healing abutment (IIP + CHA) either solely, or in combination with xenograft (IIP + Bonegraft) or with connective tissue grafting (IIP + CTG) at sites with thin labial bone in the esthetic zone. Methods Thirty-nine non-restorable maxillary teeth indicated for extraction in the esthetic zone were included. Participants were randomly assigned into three equal group; IIP + Bonegraft (Control), IIP + CTG and IIP + CHA. Midfacial gingival margin changes(mm) as primary outcome, labial soft tissue contour change(mm), interdental tissue height changes and total volume(mm 3 ) were assessed. Amount of bone labial to the implant and crestal bone level changes were also recorded. All outcomes were measured 1-year post-operative. Results The midfacial gingival margin changes demonstrated a significant difference ( P  ≤ 0.05) between the groups showing -0.98, -0.74 and -1.54 mm in sites treated with IIP + Bone graft, IIP + CTG and IIP + CHA respectively after1-year. While labial soft tissue contour change (mm), total volume (mm 3 ) and distal interdental tissue height changes (mm) revealed a significant difference after one-year between the studied groups, yet mesial interdental tissue height changes showed no difference ( P  > 0.05). Both IIP + Bone graft and IIP + CHA groups revealed a significant positive correlation between the total volume loss (mm 3 ) after 1 year and mid-facial gingival margin changes ( P  ≤ 0.05). However, no significant correlation was observed in the IIP + CTG group ( P  = 0.63). CBCT measurements showed a significant difference in crestal bone changes between the three groups ( P  ≤ 0.05), yet, there was no significant difference regarding mean amount of bone labial to the implant( P  > 0.05). Conclusions This investigation suggests that the mere presence of CTG simultaneous with IIP in the anterior maxilla reduced the midfacial gingival margin alterations (mm), besides, CTG decreased the overall volume loss (mm 3 ) by 5-folds compared to the other studied groups after one year. Meanwhile, using CHA alone with IIP failed to maintain the peri-implant soft tissues contour. Trial registration The current trial was retrospectively registered at Clinical trials.gov (ID: NCT05975515, Date: 27-July-2023).

Oral health education programs have long been considered an essential part of oral health policies. This is important for reducing the risk of oral diseases through health enhancement and voluntary behavioral changes due to learning opportunities. This study aimed to evaluate the effects of school-based oral health education program on oral health in school children in Sudan. A quasi-experimental study was conducted at four governmental schools in Khartoum, Sudan, between August 2018, and March 2022. A total of 423 school children were randomly allocated into the control (n = 211) and study (n = 212) groups. An adapted questionnaire was administered to students before and after the intervention to assess their knowledge and practice of oral health. The study group participated in oral health education activities. Data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 21. The findings revealed that the mean knowledge at the pre-educational program was 9.3066 (SD = 3.91078) and the mean knowledge after the educational program was 21.2736 (SD = 2.13982). The scores indicated that the school children had significantly higher knowledge and practice scores after the oral health education program. The study concluded that education program on oral health improved students' oral health knowledge and practices. Imposing theoretical and practical lessons on oral and dental health in school curricula can motivate students to maintain oral health care, and this improves oral health status.