Kordofan Journal of Medical & Health Sciences
The Kordofan Journal of Medical & Health Sciences (KJMHS) is a biannual, peer-reviewed, open-access scientific journal published by the Faculty of Medicine and Health Sciences, University of Kordofan, El-Obeid, Sudan. Established to advance the dissemination of medical knowledge and promote evidence-based healthcare practice, the journal provides a platform for researchers, clinicians, educators, and public health professionals to publish high-quality original research, review articles, case reports, and short communications in all fields of medical and health sciences.
Prevalence and Trends of Transfusion-Transmitted Infections Among Screened Samples During 2024-2025 at El-Obeid Central Blood Bank, North Kordofan, Sudan.
Background: Transfusion-transmitted infections (TTIs) remain a major public health challenge in low-resource settings, including Sudan, and ensuring blood safety is difficult when screening and surveillance systems are limited. Objectives: To estimate the prevalence and monthly trends of HBV, HCV, HIV, and syphilis among blood donors in El-Obeid, Sudan (2024-2025), and to compare the performance of rapid tests with ELISA in the detection of these infections. Methods: A retrospective analysis was performed using donor screening records from January 2024 to December 2025. Screening for HBV, HCV, HIV, and syphilis was performed using rapid tests and ELISA. Data were analysed in SPSS; chi-square tests were used for comparisons, and p < 0.05 was considered statistically significant. Results: A total of 211,773 screening results were reviewed. The overall prevalence of HBV, HCV, HIV, and syphilis using ELISA was 2.6%, 0.6%, 0.4%, and 4.6%, respectively. In 2025, ELISA detected significantly more positive cases than rapid tests, particularly for HBV and syphilis (p < 0.05). Monthly trend analysis showed noticeable fluctuations with mid-year peaks. Conclusion: HBV and syphilis remained the predominant TTIs among screened donors. The higher detection rate by ELISA supports its wider use for blood screening to enhance transfusion safety.
Copyright (c) 2026 Ekhlas Alrasheid Abuelfadol, Reham Abdelhady Ali Awad Elkareem, Khalid A Enan (Author)
Evaluating Quality of Midwifery Care Services in Primary Healthcare Facilities in West Kordofan Region, Western Sudan
Background: Providing quality midwifery care services is crucial to reducing maternal morbidity and mortality now and beyond 2030. The maternal mortality ratio (MMR) in the state of West Kordofan is estimated at 121/100,000 Live Births (LB). Evaluating the quality of currently provided midwifery care services will influence the plan to reduce the high MMR. Objectives: To evaluate and measure the quality of midwifery care services provided at primary health facilities in West Kordofan, Sudan. Methods: A cross-sectional community-based study was conducted in West Kordofan state, Sudan. Through this, a total of 291 primary healthcare facilities in seven municipalities and the performance of the corresponding 291 midwives were assessed using the Donabedian framework (Structure, Process, Outcome). To assess the patient-reported outcome measure, 582 patients who served in the selected primary healthcare facilities were surveyed using a five-point Likert scale. Result: The mean ±SD of the age in the midwife’s group was 34.09 ±10.3, while the mean (SD) age of the women was 30.2 ± 7.6. Assessment of the midwife’s performance was effective, expressed in percentages ranging between 75% - 96%. The midwives who received training after graduation were found to be (79.7%), and those who have been recruited in the health system were only (50%). Consumables and essential equipment were found to be adequate, with a comprehensive score of 79.34% and 74.06% respectively. Assessment of the overall women's satisfaction with midwifery revealed that 48% were very satisfied, 25% satisfied, 10% were neutral, 6% dissatisfied, and 11% were very dissatisfied. Conclusion: The current study showed that the midwifery services provided in the state of West Kordofan were of relatively acceptable quality. However, some weaknesses around investigations, family planning methods, and supervision were noticed. Therefore, quality research to generate actionable recommendations to address these weaknesses is needed.
Copyright (c) 2026 Yousif R Makki, Hamdan Z Hamdan (Author)
E-learning experience of health professional students before and during the war in Sudan
ABSTRACT Background: Amid conflict-induced displacement, which severely disrupts education, e-learning has emerged as a viable solution. This study investigates health professions students’ experiences with e-learning during the ongoing war, focusing on sex differences, displacement status, digital platforms, and educational continuity. Methodology: This was a prospective descriptive study conducted in, Aljazeera, Sinar and Kordofan universities in Sud during the period from April 2025 to June 2025. Data regarding this study was gathered using online questionnaire. Results: Despite widespread conflict-related disruptions, students reported modest improvements in their e-learning experiences (50%). Female learners comprised the majority of participants (64.3%), and paradoxically, those displaced outside Sudan (32.7%) enjoyed more reliable connectivity and greater access to digital resources. Telegram emerged as the most popular platform (85.7%), prized for its low bandwidth demands and intuitive interface. Conclusion: Although e-learning has provided a vital alternative to the collapse of education, significant barriers remain, including poor infrastructure, psychological stress, and institutional fragmentation. The findings underscore the need for targeted interventions to ensure inclusive, sustainable, and resilient digital education for conflict-affected populations.
Copyright (c) 2026 Nazik Abdallah Ahmed Saad, Hussain Gadelkarim Ahme, Samira M Ahmed (Author)
Nutritional and Health Status of Infants Under Six Months of Age in El-Obeid City, North Kordofan State
Background and Objective: This study was conducted at Elfatih Elnour Health Centre, El-Obeid, North Kordofan State, Sudan. The study aimed to evaluate the nutritional status of infants under six months of age. Materials and Methods: Forty-five infants were selected randomly from 150 infants who visited the centre for following up the growth monitoring. Primary data were collected using structured interview questionnaire and anthropometric measurements then analysed by Statistical Package for Social Sciences (SPSS) software version 16. Results: Study results revealed that, most of mothers (87%) initiated breastfeeding after birth and 76% of them breastfed their infants at the first hour after birth. Fifty-eight percent of mothers gave their infants water and artificial or animal milk before six months. Most respondents (98%) continued breast feeding and 51% of them started complementary feeding before six months. Concerning bottle feeding, 38% of respondents used them for drinking and feeding. Study findings indicated that all respondents weaned gradually due to maternal illness. Most of mothers (98%) were followed up by health cadres. There were no any signs of vitamin A deficiency among respondents. Concerning wasting measures, respondents appeared to have normal weight (70%), obese (6%), underweight (20%) and severely underweight (4%). Stunting measures, revealed that respondents were normal (91%), very tall (5%) and stopped growth (4%). Statistical analyses showed that there were no significant correlations between the initiation of complementary feeding and the continuing breastfeeding, the bottle feeding and the diseases affecting the respondents, the awareness and the monthly visit to the centre to monitor the respondents' weight, the gender of respondents and the diseases affecting respondents, the number of under-five members and the awareness of respondents’ mother. Conclusion: The study revealed generally good breastfeeding practices among mothers attending Elfatih Elnour Health Centre. Nevertheless, early introduction of complementary feeding and non-breast milk liquids before six months remains a significant concern. Nutritional education and promotion of exclusive breastfeeding are necessary to improve nutritional and health outcomes in the study area.
Copyright (c) 2026 Mohamed Elmustafa Osman Elsayed, Sahar Adam Suleiman Adam, Naglaa A. Suliman (Author)
Three-Year Outcomes of Laparoscopic Sleeve Gastrectomy at King Khalid General Hospital, Hafar Al-Batin
Background: Laparoscopic sleeve gastrectomy (LSG) is one of the most frequently performed bariatric procedures worldwide, with proven efficacy in weight loss and comorbidity resolution. However, long-term outcome data from specialized centers in Saudi Arabia are limited. Objectives: To evaluate the three-year outcomes of LSG performed at a specialized bariatric center, focusing on weight loss, comorbidity resolution, and postoperative complications. Methods: A retrospective cohort study was conducted including 50 patients who underwent LSG between January 2020 and December 2021 at King Khalid General Hospital, Hafar Al-Batin, Saudi Arabia. Data included demographics, body mass index (BMI), comorbidities, and complications. Patients were followed for 3 years. Descriptive statistics were used. Results: Of the 50 patients (15 males, 35 females; mean age 36 ± 9 years), mean BMI decreased from 42 ± 5.1 kg/m² to 30 ± 3.8 kg/m² at 3 years (%EWL: 71%). Comorbidities included type 2 diabetes mellitus (14%), hypertension (26%), hypertriglyceridemia (22%), and osteoarthritis knee pain (2%). Complete resolution was observed in all affected patients. Complications occurred in 20%, including staple line leaks (10%), all in cases performed by a visiting surgeon, conversion to Roux-en-Y gastric bypass (6%), post-stent bleeding (2%), and vitamin B12 deficiency-related complications (2%). Conclusion: LSG at a specialized bariatric center produced sustained weight loss and resolved all recorded comorbidities at three years. The higher complication rate in cases performed by the visiting surgeon points to the importance of consistent surgical expertise.
Copyright (c) 2026 Department of General and Bariatric Surgery King Khalid General Hospital, Hafar Al-Batin (Author)
Perceptions of the Medical Students towards the Learning Environment at the University of Kordofan, Western Sudan
Background: The objective of this study was to explore the students’ perceptions of the learning (educational) environment at the Faculty of Medicine, University of Kordofan; in order to identify the strengths and weaknesses as basement for the ongoing improvements. Method: A cross-sectional descriptive study was conducted among the 5th year medical students at the University of Kordofan, Western Sudan. A questionnaire was used to collect information on students’ gender, dormitory status, the study climate and their satisfaction of mentoring status. The study employed the Dundee Ready Education Environment Measure (DREEM). The collected data were then analysed using the Statistical Package for Social Sciences, (SPSS) version 26. Results: Out of the 150 registered 5th year medical students, a total of 108 participated in this study, with a response rate of 72%. Sixty-nine of the participants (64.5%) were females. The study questionnaire showed good reliability coefficient (Cronbach’s alpha) value of 0.873. The total DREEM mean score was 107.45 ± 17.56, indicating a more positive than negative response. The subscales of the students’ responses distribution had mostly indicated a more positive perception of the domains of the learning environment; students’ perception of learning (SPL) 61.4%, students’ perception of teaching (SPT) 72.2%, students’ academic self-perception (SAP)60.6%, and students’ social self-perception (SSP) 53.4%, with the exception of the students’ perception of atmosphere (SPA) where most of the students (62.7%) viewed it negatively. The study identified 18 items with weaknesses in the learning environment in need of prompt interventions. Conclusions: Perceptions of the medical students towards the learning environment at the University of Kordofan, Western Sudan are more positive than negative, and similar to the findings in developing countries. There are some weaknesses identified that need improvements
Copyright (c) 2026 El Bushra Ahmed Doumi, Rasha Doumi, Abdelhameid Ahmed el Mugabil (Author)
The Effect of Acute Diarrhea on Tacrolimus Trough Level Among Post Kidney Transplant Recipients at IBn Sina Hospital-Khartom-Sudan: A cross sectional study.
Background: Diarrhoea is very common among post kidney transplant recipients which can lead to dehydration and an increase in tacrolimus (TAC) trough level. These will lead to intoxication and loss of graft function. TAC is heavily metabolized by CYP3A4 and CYP3A5 enzymes and p-glycoprotein efflux pumps located in the mature apical enterocytes of the small intestine, acute diarrhoea selectively breaches and disrupts this localized metabolic barrier, allowing a significantly higher fraction of unchanged drug to pass directly into the portal circulation, increasing systemic trough concentrations. Objective: To assess the effect of acute diarrhoea on tacrolimus trough level among post kidney transplant recipients. Methods: This is a descriptive, cross- sectional analytical hospital-based study, conducted at Ibn Sina Hospital during the period from April to June 2021. 100 post kidney transplant recipients were enrolled in the study. 50 of them had acute diarrhoea, the other 50 had no acute diarrhoea (taken as control). Results: Regarding the range of tacrolimus trough level, the findings revealed that it was above normal (target level) in 58%(n=29) with an absolute-mean of 33.3 ,SD 24.1 of those who had acute diarrhoea compared to18%(n=9) with an absolute- mean of 33.3 , SD 23.1 of the control group, which indicates significant association between elevated trough levels of tacrolimus and acute diarrhoea among post kidney transplant recipients (P < 0.05). A high level of serum creatinine was reported in 38%(n=19) with an absolute mean of 50.0 , SD16.9 of the one who had acute diarrhoea in comparison to 18%(n=9) with an absolute mean of 50.0 , SD 45.25 of the control group, indicates significant association between elevated levels of serum creatinine and acute diarrhoea among post kidney transplant recipients (P value < 0.05). Conclusion: The study showed a significant association between acute diarrhoea and increase tacrolimus trough level among post- kidney transplant recipients. Moreover, there was a significant association between elevated levels of serum creatinine and acute diarrhoea among post- kidney transplant recipient.
Acute Diarrhea , Tacrolimus trough level, Post Kidney Transplant recipient , Kidney Allograft Rejection,Sudan,
Copyright (c) 2026 Mustafa Yaasseen Hamid Yasseen, Ahmed Elnour Ali Omer (Author)
Frequency of Tunneled Central Venous Catheters Infection in Adults on Haemodialysis at Ibn Sina Hospital -Khartoum, Sudan: A cross-sectional study
Abstract Background Global initiatives for the study of the outcomes in patients on dialysis consider the presence of catheter-related infections as a potentially devastating complication, being the most common cause of morbidity and the second of mortality. The risk of sepsis attributable to this condition is one hundred-fold greater than that of the general population. In the same way, it is considered that haemodialysis catheters represent the greatest risk of bacteremia, sepsis and death compared with other vascular accesses. Objecvtives To measure the frequency of tunneled central venous catheter infection among adult undergoing haemodialysis. Methods This is a cross sectional, descriptive, analytical hospital based study, included 81 adult patients with known history of end stage renal disease(ESRD), using tunneled central venous catheters as access to haemodialysis at Ibn Sina Hospital-Khartoum Sudan. Result: The predominant gender in this study was female gender 66.7% (n=54), as for age group, 58% (n= 47) of the study group were between 40-65 years old. 67.9% (n=55) had end stage renal disease for 1-10 years. most of the study group 96.3% (n=78) underwent two sessions of dialysis/week and the main site of tunneled central venous catheter among the patients was Internal jugular vein. Tunneled central venous catheter infection was present in 48.1% (n=39) of the study group. 86.4% (n=70) were known case of systemic hypertension, and 17.3% (n=14)had diabetes mellitus . 57% (n=46) of the study group were received prophylactic antibiotics at the time of catheter insertion. 37% (n=30) of the patients had tunneled central venous catheter for 3-6 months, 34.6% for 6 months to 2 years. old patients were more prone to catheter infection than younger groups, patients who had tunneled central venous catheter duration for 6 months and above (>2 years) were frequently infected compared to the group with less duration “<6 months”. There was a significant association with prophylactic antibiotics use at the time of insertion. Conclusion: Long duration of tunneled central venous catheter, hypertension,diabetes mellitus and old age were major risk factors related to infection in haemodialysis patients. Promotion of the infection control precautions by educating and training the health providers is needed.
End Stage Renal Disease, Heamodialysis, Central Venous Catheter Infections,CLABSI ,Sudan,
Copyright (c) 2026 Mustafa Yasseen Hamid Yasseen, Fatima Jadalmola Siralkhatim Mohammed (Author)
Management and Maternal Outcomes of Primary Postpartum Hemorrhage: A Cross-Sectional Study at Wad Medani Maternity Teaching Hospital, Sudan
Background: Primary postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide, particularly in low-resource settings. Understanding its causes, associated risk factors, and management outcomes is essential for improving maternal health. Objective: To assess the causes, risk factors, management modalities, and maternal outcomes of primary postpartum hemorrhage among women admitted to Wad Medani Maternity Teaching Hospital, Sudan. Methods: A descriptive cross-sectional hospital-based study was conducted at Wad Medani Maternity Teaching Hospital, Sudan, from October 2020 to April 2021. A total of 211 women diagnosed with primary postpartum hemorrhage were included. Data were collected using a structured questionnaire and analyzed using SPSS. Results: Uterine atony was the leading cause of primary postpartum hemorrhage (76.3%), followed by genital tract trauma (12.8%), retained placental tissue (10.0%), and coagulation disorders (0.9%). The most common risk factor was prolonged third stage of labor (74.9%), followed by episiotomy (10.4%), fetal macrosomia (6.2%), multiple pregnancy (4.7%), and previous history of postpartum hemorrhage (3.8%). Most cases (83%) were successfully managed medically, while 17% required surgical intervention. The most common surgical procedures were uterine compression sutures (16.1%), uterine artery ligation (14.7%), and hysterectomy (10.4%). The most frequent maternal complications were orthostatic hypotension (73.5%), anemia (33.6%), fatigue (25.6%), and dilutional coagulopathy (16.1%). Conclusion: Uterine atony was the predominant cause of primary postpartum hemorrhage, and prolonged third stage of labor was the most significant associated risk factor. Most cases were effectively managed with medical treatment, highlighting the importance of early recognition and prompt intervention to reduce maternal morbidity.
Copyright (c) 2026 Ahmed ELmustafa Elamin, Samiha Ali Yousif (Author)
Physiology-Driven Risk Stratification and Outcome Heterogeneity in Emergency Colorectal Cancer Presenting with Obstruction or Perforation: A Systematic Review
Background: Obstructed and perforated colorectal cancer with emergency presentation represents a high-risk clinical condition associated with significant morbidity and mortality. Although outcomes are consistently inferior to elective surgery, marked variability was demonstrated in reported mortality, operative strategy, and long-term survival across studies leading to considerable heterogeneity. Differences in reporting physiological status, sepsis severity, tumor characteristics, and lack of standardized reporting contribute to this heterogeneity. Objectives: This systematic review aimed to assess current evidence on obstructed and perforated colorectal cancer, focusing on risk stratification, physiological determinants of outcome, and variability in operative frameworks and outcome reporting. Methods: A systematic search of electronic databases including PubMed, Embase, Scopus, Cochrane Library, and Google Scholar was performed to retrieve randomized trials, meta-analyses, cohort studies, and international guidelines addressing adult emergency colorectal cancer. Primary outcomes included postoperative morbidity and short-term mortality. Secondary outcomes included stoma formation, intensive care utilization, recurrence, and survival. The review findings were synthesized narratively in accordance with PRISMA guidelines because of substantial heterogeneity in definitions of emergency presentation, obstruction, perforation, and outcome measures. Results: Obstructed and perforated colorectal cancer presenting as emergency demonstrated consistently inferior outcomes compared to elective surgery; however, morbidity and mortality rates were variably reported across literature. Perforation was associated with the highest early mortality, particularly in patients presenting with sepsis and physiological instability. Operative strategies ranged from primary resection with anastomosis to staged surgery and Hartmann’s procedure, demonstrating variability in risk assessment and institutional expertise. Substantial variations in definitions and outcomes reporting limited direct inter-study comparability. Conclusion: Perforated and obstructed colorectal cancer presenting as emergency represent a high-risk surgical condition associated with considerable morbidity and mortality. Evidence generated in this review demonstrates that outcomes are primarily determined by physiological instability, septic burden, and system-level factors, rather than tumor characteristics alone. Perforation with generalized peritonitis carries the greatest early mortality, whereas obstructive disease characterized by a broader physiological spectrum in which risk is strongly modulated by baseline physiological reserve and the timeliness of resuscitative care.
Colorectal cancer; emergency; obstruction; perforation; risk stratification; outcome heterogeneity.
Copyright (c) 2026 Abdel Latif Khalifa Elnaim, Michael Wong Pak Kai, Ismail Sagap (Author)
New-Onset Type 1 Diabetes Mellitus Triggered by COVID-19 with Severe DKA and Asymmetric Neuropathy: A Case Report
Pediatric critical care / PICU, Acute kidney injury (AKI)
Copyright (c) 2026 Alddai Alnair, Anasalwogud Ahmed, Maged Nabawi, Bashir Elnaem, Aman Sohal, Amal Sherif (Author)
When a Tooth Becomes a Foreign Body: A Rare Pediatric Airway Emergency A Case Report
Foreign body aspiration is considered as a top emergency in children, which demands immediate detection and prompt medical response. The extraction of teeth as aspirated foreign bodies is extremely rare because their sharp edges make it difficult to extract from the distal airways. A two-year-old female patient had her upper incisor tooth aspirated after a fall which resulted in multiple unsuccessful bronchoscopic retrieval attempts leading to repeated hypoxic arrests. The case shows the diagnostic and therapeutic challenges of distally impacted airway foreign bodies and performs safe and timely surgical procedures when standard bronchoscopic techniques are ineffective.
Copyright (c) 2026 Alnameir Ibrahim, Abdelrahman Eltigani, Salma Alhusain, Anfal Elhaja, Salma Aldwahi, Alddai Alnair (Author)
Clinical features and Outcome of Neonatal Conditions at El-Obeid Paediatric Specialized Hospital, Sudan
Background: Neonatal mortality accounts for 46% of under-five deaths worldwide. In Sudan, the neonatal mortality rate is 29.4 per 1000 live births. Aim: To determine the clinical characteristics and outcome of neonates admitted to El-Obeid Specialized Pediatrics Hospital in Western Sudan. Methods: Retrospective, descriptive hospital-based study. Data were collected from the medical records of newborns admitted to the hospital between January 2015 and July 2018. Relevant socio-demographic and clinical information was collected on a prepared standard form. Descriptive and analytical statistics were used to summarize the study variables. Results: A total of 1,662 neonates were enrolled during the specified period. About 56% of the cases were male. Neonatal sepsis was the most common clinical condition, occurring in 83.4% of cases. Most cases (88.3%) presented with fever and 28.7% had jaundice. The overall mortality was 2.3%, of which about a quarter occurred within the first week after birth. Conclusion: Neonatal morbidity and mortality still account for a large proportion of the burden of disease in children under 5 years of age. Identifying the risk factors associated with neonatal death is very important to guide the development of effective interventions to reduce neonatal mortality.
Copyright (c) 2026 Alam-Eldin M. Mustafa, Niemat Mohammed Tahir, Mohammed Abdullah Alshehri, Safiedin I. Elsafi, Abubakr A. Omer, Mohamed A. Desogi, Fahad A. Elnour, Nahid A. Ali, Haitham M. Awadalla (Author)
Assessment of Drinking water Quality in El-Obeid City North Kordofan State, Sudan
Background and Objective: Access to safe drinking-water is essential to health as water can become unsafe at any point between collection and consumption, this study aimed to assess the physicochemical and bacteriological quality of drinking water in El-Obeid City, North Kordofan State, Sudan (2022 – 2025). Materials and Methods: A descriptive cross-sectional study was conducted. Sample size determined according to World Health Organization (WHO) guidelines for water sampling measurement. The samples were distributed across three sources: households (20), animal carts (12), and pump/wells (8). water samples were collected and analyzed for parameters including (PH – Nitrite- Fluoride - Hardness – Calcium - Magnesium – Residual free chlorine and Total Dissolved Solids) and the presence of coliform bacteria Escherichia coli (E. coli). Results: The findings showed that 72.5% of water samples were contaminated with Escherichia coli, with the highest contamination from animal carts (83%), followed by households (70%), and pump/wells (62.5%). Conclusion: The findings emphasize the need for improved water treatment and targeted interventions to ensure safe drinking water and mitigate waterborne disease risks.
Copyright (c) 2026 Loaey Emad Eldeen Abdalla Mohmed, Somia Ali Mohammed Ibrahim (Author)
Do We Need to Follow International Guidelines for Empirical Antibiotics Selection in Critically Sick Children? A Case series
Background: Sepsis is a leading cause of pediatric critical illness and mortality. Choosing empiric antibiotics based solely on international guidance may be inadequate where local resistance patterns differ. Methods (Case Series Description): We describe two infant cases with rapidly progressive septic shock, purpuric/necrotic skin lesions, and multi-organ failure. Results: Blood/CSF/lesion cultures in both cases grew Pseudomonas aeruginosa resistant to initial ceftriaxone+vancomycin; one isolate was imipenem-susceptible after escalation. Despite maximal organ support, both infants died. Conclusion: While international guidelines standardize care, empiric therapy in critically ill children should be tailored to local epidemiology and AMR surveillance, ensuring early coverage for Pseudomonas where prevalence warrants.
Copyright (c) 2026 Anasalwogud Ahmed, Aaqib Ahmed, Maged Nabawi, Ayman Gouda, Mohamed Babiker (Author)
Comparison of Culture, GeneXpert and Two Staining Techniques with Fine Needle Aspiration in Diagnosis of Tuberculous Lymphadenitis, Khartoum, Sudan: A Prospective Cross-Sectional Study
<p class="MsoNormal" style="margin-bottom: 0in; text-align: justify; line-height: normal; mso-pagination: widow-orphan lines-together; page-break-after: avoid; mso-outline-level: 1; border: none; mso-border-left-alt: solid #C0504D 1.5pt; mso-border-left-themecolor: accent2; mso-border-bottom-alt: solid #C0504D 1.5pt; mso-border-bottom-themecolor: accent2; padding: 0in; mso-padding-alt: 0in 0in 1.0pt 4.0pt;">Introduction: Investigations of tuberculous lymphadenitis are challenging for clinicians. Using multimodality patterns may yield a better outcome. The objective is to compare the various laboratory methods; GeneXpert, culture, ZN stain and Auramine-Rhodamine stain in diagnosing tuberculous lymphadenitis. Method: This study is a prospective cross-sectional laboratory-based study. The study was conducted in Khartoum, Sudan. Specimens obtained from lymph nodes were examined cytologically, culture, GeneXpert, Auramine-Rhodamine stain and ZN stain laboratory methods were applied for all specimens, and all cases were initially diagnosed as tuberculous lymphadenitis by FNAC. Patients' sociodemographic data anthropometric measurements, clinical examination and diagnostic tools were also gathered. SPSS version 23 was used for data analysis. Results: a total number of 105 cases were included, 53.3% were males. The mean age was 27.29 ± 15.94. The most affected age group was 19 – 30 (33.3%). The most affected lymph node group was the cervical group 83 (79.0%); furthermore, 81(77.1%) patients had a single lymph node affected while 24(22.9%) cases had multiple lymph nodes. The main cytomorphological pattern identified was necrotizing granulomatous lymphadenitis 79(75.2%). GeneXpert Positive cases were (41.0%), ZN staining (4.8%), Auramine- rhodamine stain (5.7%) and culture showed growth among (45.7%) of the cases. Sensitivity against FNAC was as follow: culture 64.81%, GeneXpert 62.87%, ZN stain 51.22% and Auramine-Rhodamine stain 51.47%. On the other hand, sensitivity and specificity against culture was calculated as follow: FNAC 100%, GeneXpert 80.0%, ZN stain 51.61% and Auramine-Rhodamine stain 53.33%. Specificity, as based on culture, was as follows FNAC 54.28%, GeneXpert 89.06%, ZN stain 96.61% and Auramine-Rhodamine stain 100%. Conclusion: combining various diagnostic methods for caseating necrotizing cytomorphology cases yields less than 50% positivity. FNAC is recommended as the first-line test for suspected tuberculous lymphadenitis due to its higher sensitivity, rapidity, practicality, and cost-effectiveness. In inconclusive cases or those with a suppurative background, especially suspected TBLN, culture and GeneXpert are advised.
Copyright (c) 2026 Marwa H. Yagoub, Ahmed O Almobarak, Wadie Elmadhoun, Rasheeda Hamid Abdalla, Mohamed H Ahmed, Nuha Yousif Ibrahim (Author)
Clinical, Biochemical, and Ultrasonographic Characteristics of Women with Suspected Polycystic Ovary Syndrome in El-Obeid
Background: Polycystic ovary syndrome (PCOS) is the leading endocrine disorder among reproductive-aged women. Despite its prevalence, Sudanese data remain limited. Objectives: To describe the clinical presentation, hormonal abnormalities, and ultrasonographic findings among Sudanese women with suspected PCOS. Methods: Descriptive cross-sectional study of 120 symptomatic women aged 15–45 years. Consecutive sampling was used. Clinical evaluation, hormonal assays, and pelvic ultrasound were performed using Rotterdam criteria. Results: Menstrual irregularity (58.3%), hirsutism (47.5%), acne (41.7%), and acanthosis nigricans (38.3%) were common. Ultrasound confirmed polycystic ovarian morphology (PCOM) in 68.3%. Elevated LH/FSH ratio and testosterone were observed in 47.5% and 45% respectively. Significant correlations were found between BMI and hirsutism (r=0.52), LH/FSH ratio and testosterone (r=0.44), and ovarian volume and LH (r=0.48). Conclusion: The clustering of reproductive, hormonal, and ultrasound abnormalities highlights the classical PCOS phenotype. Early integrated diagnostic assessment is essential. Findings are not generalizable due to the hospital-based design [1,2].
Copyright (c) 2025 Kordofan Journal of Medical & Health Sciences
Musculoskeletal pain patterns in a group of Sudanese surgeons
Background: Surgeons frequently experience work-related musculoskeletal pain, which is a prevalent problem. This study aims to evaluate the patterns of musculoskeletal pain among a group of Sudanese surgeons. Methodology: This study utilized a cross-sectional survey design, in which 84 volunteers residing in the city of El-Obeid, located in the Northern Kordofan state, participated. We randomly selected contributors between May 2024 and June 2024, without taking into account their age or gender. Results: About 65.5% of the subjects, consisting of 75% females and 63% males, reported experiencing lower back pain. 43% of individuals reported experiencing neck pain, with 37.5% being women and 44% being men. The study found that males have a higher risk of experiencing neck pain. We calculated the relative risk (RR) to be 1.250, with a 95% confidence range (95%CI) of 0.501-3.122. A quarter of the participants, specifically 37.5% of females and 22% of males, reported experiencing shoulder pain. The likelihood of experiencing shoulder pain is slightly higher in females compared to males, with a relative risk (RR) of 1.178 (95% confidence interval [CI]: 0.880–1.576). Conclusion: Musculoskeletal discomfort is common among surgeons of various specialties in Sudan. The most often reported musculoskeletal pain was lower back, neck, and shoulder discomfort.
Rabaah ALadawya Mohammed Salih Elbasheri Gadkreem
Copyright (c) 2024 Kordofan Journal of Medical & Health Sciences
Fetal outcomes in traditional gold mining areas, Sudan
Background: Pregnancy during heavy metal toxicology is associated with various unfavorable consequences for both the mother and the fetus. Therefore, the aim of this study was to assess the fetal outcomes for pregnant women living in traditional gold mining areas in North Kordofan, Sudan. Methodology: The Obstetrics and Gynecology Teaching Hospital in North Kordofan State, El-Obeid City, Sudan, conducted this descriptive transaction case-control study from January 2018 to December 2023. The distribution of the 270 study participants was as follows: About 135 patients from traditional gold mining areas attended El-Obeid Obs. @ Gyn. Teaching Hospital for maternity services, and another 135 from non-gold mining areas as a control. Results: The average baby weight was 2.5–3.5 kg for 98 (83.7%) of the cases and 77 (74.7%) of the controls. Most study participants had healthy babies. The study involved 85 (44%) cases and 79 (65%) controls, with NICU admission following each case. 16(12%) of the cases and 18(14%) of the controls give birth to stillborn babies; 12(9%) and 6(5%) of the controls give birth to nonviable babies; 14(11%) and 18(14%) of the controls give birth to nonviable babies; and 4(3%) and 3(2%) of the controls give birth to congenital malformed babies. Conclusion: Exposure to these elements has altered the fetal development of pregnant women in traditionally gold-mining areas in Sudan.
Maternal and fetal outcomes of home births in Western Sudan
Background: In light of the ongoing Sudanese crisis, many pregnant women are having trouble getting the medical care they seek. Thus, the current study sought to evaluate the effects of home births in Western Sudan on both mothers and their newborns. Methodology: From January to December 2023, in the Obstetrics and Gynecology teaching hospital in El-Obeid, North Kordofan State, Sudan, we conducted a descriptive longitudinal investigation for this study. This study has recruited approximately 224 participants. Results: The most common maternal outcomes observed in this group of patients were postpartum hemorrhage, followed by puerperal sepsis and eclampsia, accounting for 14.3 percent, 13%, and 9 percent of cases, respectively. Fresh stillbirth accounted for the majority of cases, while macerated stillbirth, fetal distress, and birth trauma accounted for 28%, 17%, 15%, and 9% of the cases, respectively. Conclusion: Home birth is widespread in Sudan; however, it might harm the mother and baby. Postpartum hemorrhage, puerperal infection, and eclampsia are the main maternal consequences. Fresh stillbirth, macerated stillbirth, fetal distress, and delivery trauma are common fetal outcomes. Prioritize maternity and prenatal care system improvements
Pattern of Conjunctival Diseases in North Kordofan State
Background: The conjunctiva is one of the most important elements of the eye because it covers the anterior white sclera and reflects on the eyelids, providing protection and lubrication while also producing mucus, which is an important component of the tear film. It also serves as a protective barrier against germ entry into the eye and aids in immunity. It is highly vascularized and has numerous lymphatic vessels. Some conjunctival disorders are caused by trauma, such as subconjunctival hemorrhage and conjunctival tear, while others are caused by infection, such as trachoma and conjunctivitis. Methodology: The study was carried out at the Ophthalmology Emergency Department of surgery El-Obeid Teaching Hospital and Dr. Khalil's Ophthalmology Center in North Kordofan State, Sudan. It was retrospective, descriptive research. The study sample covered all conjunctival illnesses, data was drawn from the medical record of 1000 patients with varied eye conditions, 175 patients with conjunctival diseases were selected. Results: This study investigated 175 patients with conjunctival abnormalities to determine the frequency of these diseases in North Kordofan state. The findings showed that conjunctival illnesses were more common in men, with 95 out of 175 cases (54%) and 80 out of 175 (46%) being females. The male-to-female ratio was 1.2:1, and the age range of 21-33 years was the most frequent, accounting for 33%. This was followed by the age groups of 33-53 years, 10-20 years, <9 years, and beyond 54 years, with percentages of 20%, 19%, 18%, and 10%, respectively. Subconjunctival hemorrhage was the most common type of conjunctival illness, accounting for 54% of cases, followed by conjunctivitis 17%, pterygium 15%, conjunctival tear 9%, pinguecula 3%, conjunctival nevus 1%, and trachoma. Conclusion: Conjunctival disorders were prevalent in Northern Kordofan state, with the most common being subconjunctival hemorrhage, conjunctivitis, pterygium, and conjunctival tear.
Posterior Reversible Encephalopathy Syndrome in a Young Sudanese Female - Case Report
Introduction: Posterior reversible encephalopathy syndrome (PRES) is a rare, reversible radio-neurological condition. It commonly presents with seizures, visual disturbances, headaches, impaired level of consciousness, and other focal neurological findings. PRES is often associated with high blood pressure and can result from various causes, including autoimmune disorders, certain medications, and eclampsia. Pathophysiologically, it is characterized by reversible vasogenic cerebral edema predominantly in the occipital and parietal lobes. We report a case of a young Sudanese female with systemic lupus erythematosus (SLE), presenting with generalized seizures and headache. These symptoms occurred without fever and were associated with high blood pressure. Neuro- radiological imaging findings, typical clinical presentation, and the reversibility of the condition confirmed the diagnosis of PRES. This is, to the best of our knowledge, the first case report of PRES in SLE patients from El Obeid, North Kordofan, Western Sudan
The value of ICT and Latex Serological tests in Screening for Toxoplasma gondii
Background: Toxoplasma gondii is an intracellular zoonotic parasite responsible for infections in various warm-blooded animals and humans. This study primarily focused on evaluating the diagnostic efficacy of ICT and latex serological methods for screening Toxoplasma gondii in North Kordofan, Sudan. Methodology: This descriptive study was conducted in El-Obeid, North Kordofan State, Sudan, from January to May 2024. A total of 260 samples were collected from women who had experienced abortions or had a previous history of such events. A blood sample was collected from each respondent to conduct serological tests, including ICT, latex, and ELISA. Results: The study involved approximately 260 women to evaluate the validity of the various techniques employed. In this research, ICT and LaTeX were compared with ELIZA as the gold standard method, yielding a positive rate of 14.6% and a negative rate of 85.4% using ICT methods. However, the results from the Latex method indicated a positivity rate of 15.8%, while the negativity rate stood at 84.2%. In ELIZA, 17.3% is positive, while 82.7% is negative. The sensitivity and specificity of the techniques employed in this study are compared with the ELISA technique, as detailed in the following tests. The sensitivity achieved through the ICT technique was 84%, while the specificity reached 100% as observed in the findings. The sensitivity and specificity obtained through the latex technique were determined to be 94% and 100%, respectively. Conclusion: Both Latex and ICT demonstrate relatively better sensitivity and very good specificity, making them suitable for screening and diagnostic purposes in conflict areas.
Frequency of Hepatitis B infection among Hemodialysis Patients at Aljomih Center, ElObied, Sudan, 2024
Background and objectives: Hepatitis is inflammation of the liver due to viral infection and leads to significant morbidity and mortality. The HBV is highly infectious and the virus can be spread through vertical transmission or horizontal transmission by exposure to blood, body fluid of infected individuals. HBV infection is considered as major public health problems worldwide. This study aimed to find out Frequency of Hepatitis B infection among Hemodialysis Patients at Aljomih Center, Elobied, Sudan, 2024. Method and patients: this Descriptive cross-sectional facility- based study included all patients of hemdialysis at Aljomih center during the study period (126 patients). Results: the study showed that 8 (6.3%) of hemodialysis patients have Hepatitis B infection. Most individuals were males 97 (77.0%), and 8 (6.3%) of them were HBV positive, 29 (27%) of patient were females. The patients were classified into four age groups. Moreover, 124 (98.4%) of the patients had previous blood transfusion and 8 (6.3%) were HBsAg positive. this study elucidated that 92 (73%) of participated were hypertensive and 2 (1.58%) of them were HBsAg positive. On the other hand, 10 (7.9%) of hemodialysis patients included in this study were diabetics and all of them were HBsAg negative. Conclusion: The prevalence of hepatitis B infection among HD patient was generally high (6.3%). More effort should be done to reduce this frequency of HBV among hemodialysis patients.
Common comorbidities among tuberculosis patients in Western Sudan during the Sudan armed conflict.
Background: Tuberculosis continues to be the primary cause of death from infectious diseases globally. In low- and middle-income countries, TB significantly contributes to morbidity and mortality, particularly among patients with comorbidities such as HIV infection, diabetes mellitus, smoking, depression, chronic obstructive pulmonary disease, and pulmonary TB. HIV co-infection elevates the risk of progression to developed tuberculosis (TB) disease. This study evaluated comorbidity in tuberculosis among patients attending El-Obeid Teaching Hospital during the armed conflict from 2023 to 2024. Methodology: This descriptive retrospective study took place in the respiratory department of El-Obeid Teaching Hospital in North Kordofan State, Sudan. The study examined 751 patients diagnosed with tuberculosis, alongside detailed coverage files from the early years of the Sudan war. We collected the data in August 2024. We developed a thorough data collection sheet and methodically organized all pertinent data. Results: Of the 751 patients, 692 received a tuberculosis (TB) diagnosis without any comorbidities, making up 92% of the cohort. The remaining 59 patients, accounting for 8%, had TB with comorbidities: 40% with diabetes mellitus (DM), 29% with HIV, 15% with hypertension (HIN), and 7%, 6%, and 3% with chronic kidney disease (CKD), bronchial asthma, and cardiac disease, respectively. The majority of patients were over 60 years old, comprising 37% of the cohort. The majority of the patients were unemployed, and their tuberculosis treatment outcomes were complete. Conclusion: Tuberculosis (TB) with comorbidity is more prevalent in diabetic patients than in those with HIV. We recommend regular screening for chronic comorbid diseases to improve treatment outcomes and minimize complications. Additionally, promoting outpatient care is essential for improving TB management, and further surveillance is necessary to fully understand the extent of the issue.
Twin pregnancy generally represents a high-risk pregnancy, but monozygous twin pregnancy is a particular challenge for the obstetrician due to the serious complications that may occur during its evolution. A very rare, severe complication of monozygous twin pregnancy, which we recently dealt with in the Obstetrics and Gynecology Department of the Omdurman maternity Hospital Sudan, was a monochorionic monoamniotic twin pregnancy with acardiac twin (TRAP). One of the fetuses (acardiac twin) presented as amorphous mass without any recognizable structure, being transfused by the other fetus with a normal heart (pumping twin). The understanding of these cases is mandatory in order to offer maximum survival and heath chances to the viable fetus.
Extrapulmonary tuberculosis in Western Sudan during the armed conflict 2023-2024
Background: Tuberculosis represents one of the foremost infectious cause of mortality globally; the disease is endemic in Sudan and has experienced a significant increase amid the ongoing armed conflict. This study aims to investigate extrapulmonary tuberculosis in Western Sudan during the conflict period from 2023 to 2024. Methodology: A descriptive retrospective study was conducted at El-Obeid Teaching Hospital in North Kordofan State, Sudan, from August 2023 to September 2024. This was conducted on 233 patients diagnosed with extrapulmonary tuberculosis from a total of 751 patients with tuberculous infections. The study collected all data related to the patients from the hospital records during the specified period from 15 April 2023 to 15 April 2024. A total coverage of all patients diagnosed with extrapulmonary tuberculosis within the designated time frame, irrespective of any inclusion or exclusion criteria. Results: The data revealed that 65% were males and 35% were females. The most prevalent age group is > 46, followed by < 18, 26-35, and 36-45, with incidence rates of 37%, 18%, 17%, and 13%, respectively. The majority of the patients (59%) lived in urban areas, while 41% in rural areas.63% of them were married, while 35% were single. Tuberculous lymphadenitis was the most prevalent type of extrapulmonary tuberculosis, followed by tuberculous pleuritis, abdominal TB, spinal TB, tuberculous pericarditis, and TB meningitis (39%, 28%, 14%, 12%, 5%, and 2%, respectively). Conclusion: Extrapulmonary tuberculosis is widespread in western Sudan, with tuberculous lymphadenitis and tuberculous pleuritis being the most common manifestations of the disease. This study indicates greater values than what was previously recorded in the world. In Western Sudan the disease primarily affects middle-aged males, with the majority of cases presented beyond the 2 months period. The near-collapsed economy, the inadequately equipped health system, and the detrimental effects of the armed conflict were the primary factors in the study's findings.
Assessment of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio as Inflammatory Markers among Sudanese Patients with Chronic Kidney Disease in Kordofan state- 2024
Background and Objective: Low grade chronic inflammation is one of the central pathophysiological factors in chronic kidney disease (CKD). The complete blood count is a routine, inexpensive and easy test that provides information about formed blood contents. Neutrophil/lymphocyte ratio )NLR) and platelet lymphocyte ratio (PLR) are simple parameters and novel inflammatory marker, which may be used in many diseases for predicting inflammation. The aim of this study is to assess the utilization of NLR And PLR as inflammatory markers in patient with CKD. Methods: A cross- sectional descriptive study including 59 participants at different stage of CKD which was conducted. CKD was assessed based on glomerular filtration rate (GFR). Quantitative C-reactive protein (CRP) was analyzed by a fluorescence immunochromatographic methods as the bench inflammatory marker. NLR and PLR were calculated after complete blood count was performed. Results: Based on CRP value the participants were subdivided into two groups the first is group without inflammation (CRP <1) and the second with inflammation (CRP > 1). The study revealed the mean of NLR was slightly higher (3.08) in the group that had inflammation, unlike other (2.78). while the mean PLR within normal range in two groups (inflamed = 132.5, non-inflamed = 151.7). our study was showing positive correlation between NLR and CRP (R= 0.05, P= 0.000). with regards to PLR and CRP the correlation was not significant. Conclusion: Depending of these results, it can be concluded that NLR, together with CRP, may serve as a marker of systemic low-grade inflammation in patients with CKD. Larger prospective cohort studies in various ethnic groups are required to assess the possibility of using NLR as an alternative marker for CRP in patients with CKD.
Relationship Between Obesity and Hypertension among Sudanese Hypertensive Patients Attending Health Centers in El-Obeid City, North Kordofan State, West of Sudan
Background: Hypertension has been recognized as the most common cardiovascular disorder and a major risk factor for cardiovascular diseases (CVDs), chronic kidney disease, cognitive impairment and loss of vision. It is known as ‘the "silent killer" because it can be asymptomatic for many years. Obesity and/or abdominal obesity, are the main hypertensinogenic factor. Objectives: The aim of this study is to determine the relationship between obesity indices and hypertension among Sudanese hypertensive patients. Methodology: A cross-sectional hospital-based study was conducted in three health centers in El-Obeid city, West Sudan. Data were collected on anthropometric measurements (height, weight, Body Mass Index (BMI), waist circumference WC) and blood pressure (BP) measurement. The data were analyzed by the Statistical Package of Social Science (SPSS) software version 23.0. Independent sample t test, Chi-square (χ2) test and Pearson’s correlation coefficient were used. p value of ≤ 0.05 was taken as measure of statistical significance. Results: A total of 100 subjects, 19 males and 81 females, were voluntary enrolled in this study. The mean age was 53.05 (±8.28), the mean value of BMI was 28.21 (± 5.577), WC was 92.79 ± 11.009, SBP was 138.20 (±14.591), DBP was 85.50 (±9.252). Thirty-seven, (37%) were overweight, (33%) were obese, (25%) milled (class Ι), (6%) moderate (class ΙΙ) and (2%) severe obesity (class ΙΙΙ). Seventy-six, (76%) have central obesity (WC >102 cm for men and >88 cm for women). There was a statistically significant positive correlation between BMI and WC (p < .001), BMI and SBP (p = .045), WC and SBP (p = .026), WC and DBP (P = .001). Conclusion: Hypertensive patients had a high prevalence of overweight, obesity, abnormal/high BMI, and WC (central obesity). BMI and WC were positively correlated with BP. Lifestyle modification toward weight reduction is recommended in these patients. Additionally, obese persons must pay attention to their weight and try to lose weight to prevent hypertension.
Case Report, Red Blood Cell Autoagglutination: A laboratory challenge
Introduction: Red cell agglutination or autoagglutination is a phenomenon in which red blood cells clump together, forming aggregates. It is caused by the surface of the red cells being coated with antibodies. This often occurs in cold agglutinin disease, a type of autoimmune hemolytic anemia in which people produce autoantibodies (termed cold agglutinins) [1]. Sometime may develop cold agglutinins from lymphoproliferative disorders, from infection with Mycoplasma pneumoniae or Epstein–Barr virus, or idiopathically. Cold agglutinins (CA) are monoclonal or polyclonal antibodies activated at low temperatures and lead to autoagglutination of the RBC membrane [2]. Binding of CA causes agglutination of erythrocytes and the antigen-antibody complex induces complement-mediated hemolysis. Intravascular hemolysis occurs due to direct complement mediated lysis while extravascular hemolysis is as a result of C3b coated red cell destruction by macrophages in the liver [3]. Patients show hemolytic anemia of varying degrees of severity, as well as episodes of hemoglobinuria and acrocyanosis, which arise or worsen upon exposure to low temperatures. Blood cell aggregates are counted as single cells by the automated analyzers used to run complete blood count tests [4]. This leads to a markedly decreased red blood cell count and hematocrit and markedly elevated mean cell volume and mean cell hemoglobin concentration. Red cell agglutination also interferes with routine methods for blood typing and blood compatibility testing, which rely on agglutination reactions. [5,6]