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Trimetallic nanoparticles (TMNPs) have emerged as a pivotal area of research due to their unique properties and diverse applications across medicine, agriculture, and environmental sciences. This review provides several novel contributions that distinguish it from existing literature on trimetallic nanoparticles (TMNPs). Firstly, it offers a focused exploration of TMNPs, specifically addressing their unique properties and applications, which have been less examined compared to other multimetallic nanoparticles. This targeted analysis fills a significant gap in current research. Secondly, the review emphasizes innovative biosynthesis methods utilizing microorganisms and plant extracts, positioning these green synthesis approaches as environmentally friendly alternatives to traditional chemical methods. This focus aligns with the increasing demand for sustainable practices in nanotechnology. Furthermore, the review integrates discussions on both medical and agricultural applications of TMNPs, highlighting their multifunctional potential across diverse fields. This comprehensive perspective enhances our understanding of how TMNPs can address various challenges. Additionally, the review explores the synergistic effects among the different metals in TMNPs, providing insights into how these interactions can be harnessed to optimize their properties for specific applications. Such discussions are often overlooked in existing studies. Moreover, this review identifies critical research gaps and challenges within the field, outlining future directions that encourage further investigation and innovation in TMNP development. By doing so, it proactively contributes to advancing the field. Finally, the review advocates for interdisciplinary collaboration among material scientists, biologists, and environmental scientists, emphasizing the importance of diverse expertise in enhancing the research and application of TMNPs.

As part of our surveys of the invasive malaria vector Anopheles stephensi in four Sudanese states, including North and South Kordofan, Sennar, and White Nile, we collected 166 larvae. Our morphological identification confirmed that 30% of the collected mosquito samples were Anopheles species, namely An. gambiae s.l. and An. stephensi, while the 117 Aedes specimens were Ae. luteocephalus (39%), Ae. aegypti (32%), Ae. vexans (9%), Ae. vittatus (9%), Ae. africanus (6%), Ae. metalicus (3%), and Ae. albopictus (3%). Considering the serious threat of Ae. albopictus emergence for the public health in the area and our limited resources, we prioritized Ae. albopictus samples for further genomic analysis. We extracted the DNA from the three specimens and subsequently sequenced the cytochrome oxidase 1 (CO1) gene and confirmed their identity as Aedes albopictus and their potential origin by phylogenetic and haplotype analyses. Aedes albopictus, originating from Southeast Asia, is an invasive key vector of chikungunya and dengue. This is the first report and molecular characterization of Ae. albopictus from Sudan. Our sequences cluster with populations from the Central African Republic and La Réunion. Worryingly, this finding associates with a major increase in chikungunya and dengue outbreaks in rural areas of the study region and might be linked to the mosquito’s spread across the region. The emergence of Ae. albopictus in Sudan is of serious public health concern and urges for the improvement of the vector surveillance and control system through the implementation of an integrated molecular xenosurveillance. The threat of major arboviral diseases in the region underlines the need for the institutionalization of the One Health strategy for the prevention and control of future pandemics.

Anopheles stephensi is an invasive Asian malaria vector that initially emerged in Africa in 2012 and was reported in Sudan in 2019. We investigated the distribution and population structure of An. stephensi throughout Sudan by using sequencing and molecular tools. We confirmed the presence of An. stephensi in eight border-states, identifying both natural and human-made breeding sites. Our analysis revealed the presence of 20 haplotypes with different distributions per state. This study revealed a countrywide spread of An. stephensi in Sudan, with confirmed presence in borders states with Chad, Egypt, Eritrea, Ethiopia, Libya, Republic of Central Africa, and South Sudan. Detection of An. stephensi at points of entry with these countries, particularly Chad, Libya, and South Sudan, indicates the rapid previously undetected spread of this invasive vector. Our phylogenetic and haplotype analysis suggested local establishment and evolutionary adaptation of the vector to different ecological and environmental conditions in Sudan. Urgent engagement of the global community is essential to control and prevent further spread into Africa.

Background Malaria is a life-threatening public health problem globally with particularly heavy burden in the sub-Saharan Africa including Sudan. The understanding of feeding preference of malaria vectors on different hosts is a major challenge for hindering the transmission cycle of malaria. In this study, blood meals taken by blood-fed Anopheles mosquitoes collected from the field in malaria endemic areas of Sudan were analysed for source of blood meal and malaria parasite presence. Methods Anopheles mosquitoes were collected from different regions in Sudan: Khartoum state, Sennar state, Northern state, and El Gedarif state between September 2020 and February 2021. Anopheles mosquitoes were collected using the standard pyrethrum spray catch and back-pack aspirator. Mosquito samples were sorted and morphologically identified to species level using international identification keys. Morphologically identified mosquito species were also confirmed using PCR. Genomic DNA was extracted from mosquitoes for molecular identification of blood meal source and parasite detection. The presence of Plasmodium species DNA in each mosquito sample was investigated using semi-nested PCR. Frequency of each blood meal source, Anopheles mosquito vector, and malaria parasite detected was calculated. Positivity rate of each fed female Anopheles mosquito was calculated for each species. Results A total of 2132 Anopheles mosquitoes were collected. 571 (26.8%) were males and 1561 (73.2%) were females classified based on their abdominal status into 1048 (67.1%) gravid, 274 (17.6%) fed, and 239 (15.3%) unfed females. Among the blood fed Anopheles mosquitoes, 263 (96.0%) were morphologically identified and confirmed using PCR to Anopheles arabiensis , 9 (3.3%) to Anopheles stephensi , and 2 (0.7%) to Anopheles rufipes . Of 274 blood-fed An. arabiensis , 68 (25.9%) fed on mixed blood meals from human and cattle, 8 (3.0%) fed on cattle and goat, and 13 (4.8%) fed on human, cattle and goat. For single blood meal sources, 70 (26.6%) fed on human, 95 (36.1%) fed on cattle, 8 (3.0%) fed on goat, and 1 (0.4%) fed on dog. While An. rufipes and An. stephensi fed on dog (2; 0.75%) and cattle (9; 3.3%), respectively. Plasmodium parasite detection in the blood meals showed that 25/274 (9.1%) An. arabiensis meals were positive for Plasmodium vivax and 19/274 (6.9%) An. arabiensis meals were positive for Plasmodium falciparum . The rate of positivity of An. arabiensis with any Plasmodium species was 16.7%. However, the positivity rate with P. falciparum only was 7.2%, while P. vivax was 9.5%. Both An. rufipes and An. stephensi were having positivity rates of 0.0% each. Conclusions This study which was mainly on blood-fed Anopheles mosquitoes showed a diversity in the type of diet from human, cattle, and goat. Anopheles mosquitoes especially An. arabiensis in Sudan, are opportunistic blood feeders and can feed broadly on both human and cattle. The application of blood meal identification is not only important in malaria vector epidemiological surveillance but also is very useful in areas where arthropods exhibit zoophilic feeding behaviour for mammals.

Background Malaria remains a major health issue worldwide, and has long been a challenging threat in Sudan. This study aims to provide analysis of malaria prevalence, incidence, and associated fever incidence and deaths, shedding light on the evolving burden of the disease in Sennar State, Sudan, to contribute valuable data to the global understanding of malaria epidemiology. Methods A descriptive cross-sectional study was conducted in Sennar State from 2018 to 2020. Data were collected through individual interviews using open-ended questionnaires to assess malaria-related fever and death and through parasitological confirmation of malaria infection using rapid diagnostic tests. Frequencies of fever incidence, malaria prevalence, and malaria-related death were calculated, alongside malaria fever incidence rates per 1000 population and annual percentage changes in malaria prevalence. Results A total of 2027 households were surveyed, with 503 in 2018, 516 in 2019, and 1008 in 2020, covering 8372 individuals. Fever prevalence was 41.0% in 2018, increased to 58.5% in 2019, then declined to 48.4% in 2020, with incidence rates varying across localities. Overall malaria prevalence rose from 2.8% in 2018 to 4.8% in 2019 before falling to 3.3% in 2020. According to localities, Abu Hujar consistently reported the highest malaria prevalence (13.6% in 2019; 9.5% in 2020), while Aldali reported none in 2018–2019. Malaria-related deaths totaled 12 in both 2018 and 2019, increasing to 22 in 2020, mainly in Sharg Sennar and Alsouki. The annual percentage changes in malaria prevalence showed a 71.4% increase in Sennar locality between 2018 and 2019 and a 31.2% state-level reduction between 2019 and 2020, underscoring locality-specific fluctuations in transmission. Conclusions Malaria prevalence, incidence, fever incidence, and mortality fluctuated across Sennar state, with higher burden in rural areas. Findings highlight the need for sustained surveillance, diagnostics, and tailored, cost-effective interventions to inform policy and advance malaria control.

Background: Ischemic heart disease and stroke kill 25% of people worldwide. Vitamin K antagonist (warfarin) is the most widely used oral anticoagulant. Although affordable and effective, its usage is limited in many patients due to anticoagulation level variability and other factors, its alternatives include new nonvitamin K antagonist oral anticoagulants (NOACs). The study aims to investigate NOAC usage barriers. Methods: This is an observational, cross‐sectional study, involved 144 doctors from different specialties and different medical degrees in Khartoum state, the data were collected by an author designed close‐ended questionnaire. Data were entered, cleared and analyzed using Statistical Package for Social Sciences (SPSS) V25.0 software. Results: Medicine was most common (45.8%) among 144 medical department participants. The most prevalent medical degrees were registrars (25%) and doctors (25%). Specialists (22.9%), then house officers (15.3%). Over half (51.4%) had worked less than 5 years. 50% did not know about the 2021 DOACs guideline. 60.4% claimed DOACs’ unavailability inhibits prescription. The lack of a multidisciplinary team approach hinders DOACs prescription, said 70.2%. Conclusion: Sudanese clinicians’ hurdles to using NOAC for thromboembolic episodes were explored. Lack of a reversal agent and multidisciplinary team approach hinder DOAC prescription. Lack of information about international guidelines, since most participant’s preferred specialized advice or personal experience, and high DOAC costs and inaccessibility and unavailability are other important barriers. Medical practitioners should update guidelines and government insurance plans should include DOACs. Each department should start studies separately.

Background The currently used malaria vaccine, RTS,S, is designed based on the Plasmodium falciparum circumsporozoite protein (PfCSP). The pfcsp gene, besides having different polymorphic patterns, can vary between P. falciparum isolates due to geographical origin and host immune response. Such aspects are essential when considering the deployment of the RTS,S vaccine in a certain region. Therefore, this study assessed the genetic diversity of P. falciparum in Sudan based on the pfcsp gene by investigating the diversity at the N-terminal, central repeat, and the C-terminal regions. Methods A cross-sectional molecular study was conducted; P. falciparum isolates were collected from different health centres in Khartoum State between January and December 2019. During the study period, a total of 261 febrile patients were recruited. Malaria diagnosis was made by expert microscopists using Giemsa-stained thick and thin blood films. DNA samples were examined by the semi-nested polymerase chain reaction (PCR). Single clonal infection of the confirmed P. falciparum cases, were used to amplify the pfcsp gene. The amplified amplicons of pfcsp have been sequenced using the Sanger dideoxy method. The obtained sequences of pfcsp nucleotide diversity parameters including the numbers of haplotypes (Hap), haplotypes diversity (Hapd), the average number of nucleotide differences between two sequences (p), and the numbers of segregating sites (S) were obtained. The haplotype networks were constructed using the online tcsBU software. Natural selection theory was also tested on pfcsp using Fuand Li’s D, Fuand Li’s F statistics, and Tajima’s D test using DnaSP. Results In comparison with the different pfcsp reference strains, the Sudanese isolates showed high similarity with other African isolates. The results of the N-terminal region showed the presence of 2 different haplotypes with a Hapd of 0.425 ± 0.00727. The presence of the unique insertion of NNNGDNGREGKDEDKRDGNN was reported. The KLKQP motif was conserved in all the studied isolates. At the central repeat region, 11 haplotypes were seen with a Hapd of 0.779 ± 0.00097. The analysis of the genetic diversity in the C-terminal region showed the presence of 10 haplotypes with a Hapd of 0.457 ± 0.073. Several non-synonymous amino acids changes were also seen at the Th2R and the Th3R T-cell epitope regions including T317K, E317K, Q318E, K321N, I322K, T322K, R322K, K324Q, I327L, G352N, S354P, R355K, N356D, Q357E, and E361A. Conclusions In this study, the results indicated a high conservation at the pfcsp gene. This may further contribute in understanding the genetic polymorphisms of P. falciparum prior to the deployment of the RTS,S vaccine in Sudan.

One of the most frequently impacted locations by psoriasis is the scalp. It is seen in about 80% of psoriasis cases worldwide, and its treatment is challenging. To compare the efficacy and safety of excimer light versus topical methotrexate (MTX) 1% hydrogel in treatment of scalp psoriasis. This randomized prospective intra-patient comparative study was carried out on 30 patients with scalp psoriasis. Lesions were divided randomly into two areas: Area A and Area B. Area A received biweekly sessions of 308-nm excimer light and Area B received topical MTX 1% hydrogel once daily for 3 consecutive months. Psoriatic Scalp Severity Index (PSSI), itching score, patient satisfaction and dermoscopic red dots and white scales were used for assessment at the baseline, at the end of treatment protocol and 1 month after the last treatment session. Both treatment modalities induced significant improvement in PSSI, itching score and dermoscopic red dots and white scales (p < 0.001 for each). The mean percentage of improvement of PSSI was 75.82 ± 33.72 in Area A and 74.19 ± 31.64 in Area B with non-significant difference between both areas (p = 0.763). Moreover, the mean percentage reduction of itching score was 77.40 ± 24.61 in Area A and 67.67 ± 34.94 in Area B with non-significant difference between both areas (p = 0.430). Additionally, a notable improvement in dermoscopic red dots and white scales was observed in 83.3% of patients in Area A and in 60% in Area B at the end of treatment protocol with non-significant difference between both areas (p = 0.518) (p = 0.436). Marked patient satisfaction was noticed in both areas with non-significant difference between both areas (p = 0.433). 308-nm excimer light and topical MTX 1% hydrogel are equally safe and effective treatment options for scalp psoriasis with minimal side effects.

Background Postgraduate education is embracing journal clubs (JCs), which provide a platform for members to critically evaluate research articles and extract evidence-based nursing practice. The implementation of JCs by postgraduate nurses, especially in varied educational contexts such as Egypt, remains underexplored. This study aimed to explore and gain valuable insights into the professional experiences of implementing JCs among postgraduate nursing students in Egypt. Methods A qualitative study utilizing focus group discussions (FGDs) was conducted with 42 postgraduate nursing students between September and December 2024. The participants were selected through purposive sampling. The inductive thematic analysis revealed several key themes. Results The study identified five main themes: familiarity with JCs, benefits of JCs, preparation and implementation, challenges, and recommendations for enhancing the effectiveness of JCs. This study highlights the significance of JCs in promoting evidence-based nursing competencies, cultivating a research-oriented culture, and enhancing clinical application. Participants expressed concerns regarding time constraints and insufficient training, highlighting areas for improvement. It suggests integrating JCs into curriculum, aligning professional and academic responsibilities, and offering foundational research methodology training. Conclusions The findings show that JCs are viewed by participants as worthwhile learning experiences that foster research literacy, academic development, and transferable skills including critical thinking, communication, and partnership. To enhance the effectiveness and sustainability of curriculum-integrated JCs, several strategies could be implemented: providing faculty training and introductory workshops in research appraisal; intentionally incorporating JCs into the nursing curriculum; allowing participants’ clinical and academic obligations; utilizing virtual platforms; and ensuring fair access to research materials. These observations, when combined, support the pedagogical worth of JCs as organized, practice-based learning resources that connect clinical education and research. Clinical trial number Not applicable.

Objectives Toxoplasma gondii is an opportunistic parasite that causes a clinical manifestation known as toxoplasmosis. We investigated the prevalence and potential risk factors of T. gondii infection among women in Khartoum, Sudan. A sero-parasitological cross-sectional study included 100 women aging between 15 and 50 years old was conducted between January and November 2018. Serum samples were collected and investigated for the presence of anti- T. gondii immunoglobulins. Results Mean age of the women population included was 26.75 ± 8.25 with a range between 15 and 50 years. Sero-prevalence of T. gondii antibodies was 27% (27/100) with a 95% confidence interval (CI) of 18.6–36.8%. Among seropositive population 81% (22/27), 15% (4/27) and 4% (1/27) were seropositive for IgG antibodies, IgM antibodies and both antibodies respectively. Age group 21–30 years old had the highest frequency of detected IgG (10/45) and IgM (3/45). Married women had the highest frequency of detected IgG or IgM, 18/79 and 3/79, respectively. Risk factors analysis showed a total of 37/100 participants were having direct contact with cats and 66/100 have a frequent raw meat consumption, neither direct cats contact nor raw meat consumption had a statistically significant association with seropositivity to T. gondii (P value = 0.052 and 0.565, respectively).