Etiological associations of cerebral venous sinus thrombosis among adult sudanese patients: a multicenter cross-sectional study.

Cerebral venous sinus thrombosis (CVST) is a common condition that, if not detected and treated promptly, carries a high risk of morbidity and mortality. CVST's most common aetiological associations are post-partum, pregnancy, and oral contraceptive pills. The purpose of this study was to look into the aetiology of CVST in Sudanese patients in neurological centres in Khartoum state. Methodology: This was a cross-sectional hospital bases study conducted on CVST patients at four neurological centres in Khartoum state in the period from March to October 2020. Patients were studied for the aetiological association of CVST using a standardized questionnaire including medical history, clinical examination, investigation, and treatment. Results: The study included about 60 patients, 50 of whom were female (83.3%) and 10 of whom were male (16.7%). In terms of clinical presentation, almost all patients had headache, followed by visual disturbances in 49 (81.7%), seizures in 46 (76%), disturbed consciousness in 12 (20%), and weakness in 12 (20%). The most common sign was abnormal speech, which was found in eight patients (13.3%), memory disturbances in eight patients (13.3%), evidence of CN VI lesion in three (5%), papilledema in 49 (81.7%), and hemiparesis in 46 (76.7%), while abnormal sensory signs were found in only one patient. The most common aetiological association were pregnancy in 15 (25%), oral contraceptive pills in 11(18.3%), and being in the post-partum period in 23(38.3%). All of the patients' magnetic resonant imaging/magnetic resonant venography results were abnormal. Six patients had extensive sinus involvement, 35 had superior sagittal sinus involvement, and 19 had transverse sinus involvement. After treatment, 45 patients (75%) fully recovered, 11 (18.3%) partially recovered, and 4 (6.7%) died. Conclusion: Post-partum, pregnancy, and oral contraceptive pills were the most common aetiological associations of CVST compared with other populations.

Clinical profile and risk factors of cerebral venous sinus thrombosis (CVST) in Sudan: A multicenter cross-sectional study.

Background: Cerebral venous sinus thrombosis (CVST) is a relatively uncommon cause of stroke that mainly affects young ladies, with a wide spectrum of symptoms severity, and prognosis. In this study, we aim to study the clinical profile and Risk Factors of CVST among Sudanese patients in Khartoum state hospitals. Methods: This was a multi-center cross-sectional hospital-based study that covered 37 participants in three major hospitals in Khartoum, with radiologically confirmed Cerebral Venous Sinus Thrombosis (CVST). Results: About 37 patients were included in this study. The median age was 35 years; the range was 52 years, with a minimum age of 23 years and a maximum of 75 years. The commonest presenting feature was headache (n = 35; 94.6%), followed by blurring of vision (n = 25; 67.6%), while seizures is a presenting symptom in nearly half of the patients (n = 17; 45.9%), on examination papilledema was present in 83.8%. In this study 13.8% were pregnant, 31.0% were postpartum and OCPS users account for 27%. Regarding the involved sinus; Sagittal Venous Sinus and the transverse sinus were the most affected sinuses. Regarding treatment options: "low molecular weight heparin followed with warfarin" was found in 81.1%, followed by heparin in only 10.8%, while the new agents NOACs comprised only 8.1%. Conclusion: Cerebral Venous Sinus Thrombosis is mainly a disease of child-bearing women, although significant proportions of men were affected. Cerebral Venous Sinus Thrombosis presents in a wide variety of signs and symptoms.

Extensive myocardial infarction complicated with stroke as the first presentation of HIV in A young sudanese male: A case report.

Introduction: As it is a disseminated disease, HIV infection can be associated with significant cardiovascular and neurological complications; however, this commonly occurs late. Here, we highlight the unusual initial presentation of HIV infection, which is myocardial infarction complicated by stroke. Case presentation: A 30 years old male with a clear medical background presented with severe chest pain with evidence of ischemia on ECG and positive serum troponin. he received anti-ischemic drugs, and was prepared for coronary angiography with routine investigations tested positive for HIV; however, his condition was later complicated by stroke. Discussion: Antiretroviral medication, HIV disease characteristics, female gender, and HCV co-infection are risk factors for coronary artery disease (CAD) in HIV patients. Patients living with HIV are also at risk of developing stroke, which can be caused by atherosclerosis of the major arteries, small artery disease, cardiac embolism, CNS infections, coagulation issues, and non-atherosclerotic vasculopathy. Conclusion: The presentation of an acute coronary syndrome in a young patient should raise suspicion of uncommon causes and needs a prompt evaluation from digging up in history, detailed examination, and investigations with close follow-up to prevent the complications that may occur. on the other hand, known HIV Patients should be screened periodically with an electrocardiogram.

Electrocardiographic Changes and Serum Troponin Levels in Patients with Acute Stroke: A Prospective Cross-Sectional Study.

Background: Electrocardiographic changes and elevated serum troponin are frequent findings in acute stroke. They may reflect what is known as the neurogenic myocardial injury. The aim of this study is to determine the electrocardiographic changes and serum troponin level in acute stroke patients and to correlate these changes to the anatomical location and pathological type of the stroke. Methods: A prospective cross-sectional study was conducted at the National Center of Neurological Science, from January to December 2019. Non-probability sampling with total coverage was considered. 50 patients with acute stroke were included in the study. Data were analyzed by using (SPSS) version 25. Standardized ECG was performed in the first hours of admission. 2 samples from each patient were obtained for serum troponin with at least 8 hours apart. Results: All patients had wide variants of ECG changes. But tachycardia was the most frequent one identified in 54% of patients (n=50). Half of them were found to have an anterior circulation stroke. 14% of patients (n=50) have positive troponin; ECG changes are identified in all patients who represent positive troponin 100% (7 patients). Moreover, anterior circulation stroke was recognized in all patients with a positive troponin I marker. Conclusion: This study suggests that ECG abnormalities in patients with acute stroke are very common, especially tachycardia. The site of the lesion appears to play a major factor as a cause of the genesis of arrhythmia. Serum troponin elevation may play a role in diagnosing neurocardiogenic injury; nevertheless, ECG appears to be more sensitive and familial.

AstraZeneca COVID-19 vaccine: A possible risk factor for ischemic stroke and cerebral venous sagittal sinus thrombosis: A case series.

One of the most prevalent neurological impairments is cerebrovascular accident (CVA). Ischemic stroke and CVST have been linked to the AstraZeneca COVID-19 vaccine. Three Sudanese patients developed these diseases after receiving the AstraZeneca COVID-19 vaccine, indicating a relationship between the AstraZeneca COVID-19 vaccine and these conditions.

Treatment-seeking behaviour, awareness and preventive practice toward malaria in Abu Ushar, Gezira state, Sudan: a household survey experience from a rural area.

BACKGROUND: Usage of mosquito bed nets and the practice of other prevention methods are essential for the prevention of malaria in endemic areas. Proper community knowledge about malaria and prompt treatment-seeking behaviour for early diagnosis and treatment are crucial for eliminating the disease. This study aimed to assess the awareness, treatment-seeking behaviour, and prevention practices towards malaria in Abu Ushar, Gezira State, Sudan. METHODS: A community-based, cross-sectional study was conducted in March 2021, including 310 households in Abu Ushar, Aljazeera, Sudan. Data were collected through face-to-face interviews with head of the household using an interviewer-administered questionnaire. Data were entered and analysed using R software. RESULTS: A total of 310 households were enrolled in this study. Sixty per cent had children under the age of 5 years. The majority of these households (94.8%) had a history of malaria in the past 12 months. Overall, awareness of malaria was good; 197 (63.5%) households had bed nets in their houses; 75.8% of total households identified fever with shivering as a symptom of malaria. Regarding treatment-seeking behaviour, 77.9% seek treatment from the nearby primary health centre, and 60% seek treatment within the first day. Only 45.3% stated that everyone in the household sleeps under bed nets. CONCLUSION: High awareness about malaria and preventive measures was found among participants in households. Most households had previous infections with malaria. Therefore, an interventional programme should be established in this area to reduce this high rate of malaria.

Clinical characteristics, complications, and predictors of outcome of hospitalized adult Sudanese patients with COVID-19 and malaria coinfection in Sudan: A multicenter retrospective cross-sectional study.

Malaria and coronavirus disease 2019 (COVID-19) share several characteristics that could lead to cross-infection, particularly in malaria-endemic areas. Early COVID-19 symptoms might be misdiagnosed for malaria in clinical settings. Also, both diseases can cause fatal complications. So, laboratory testing for both diseases was recommended by the World Health Organization. To study the clinical characteristics and outcomes of Adult Sudanese patients with COVID-19 and malaria coinfection. This retrospective cross-sectional study was conducted from January 2021 to October 2021 in Wad Medani. Total coverage of all Sudanese patients above 18 years old with a confirmed diagnosis of coinfection with COVID-19 and malaria was included, and data were collected using a data collection sheet. Data were analyzed using R software version 4.0.2. Data were described and presented as mean, standard deviation, and number (percentage). To find associated factors with in-hospital outcome, χ2 test, fisher exact test, and independent t test or Wilcoxon rank-sum test were used. In this study, 156 participants were diagnosed with COVID-19 and malaria coinfection. Most of them were between 60 and 70 years (30.8%), the majority were males (59%). Shortness of breath (76.3%) and acute respiratory distress syndrome (35.3%) were the most common symptom and complications among coinfected patients, respectively. Ground glass opacity (n = 47/49, 95.9%) is the most common result for computed tomography scan. Atrial fibrillation was the most common abnormal electrocardiogram finding (n = 6/62, 9.7%). Overall mortality among all participants was (63/156, 40.4%). High mortality rate was found among the coinfected patients. More attention is needed towards fighting COVID-19 and malaria coinfection. There may be a link between malaria and COVID-19.

Clinical Characteristics and Risk Factors Associated with Severe Disease Progression among COVID-19 Patients In Wad Medani Isolation Centers: A Multicenter Retrospective Cross-Sectional Study.

Background: Since December 2019, (COVID-19) has had a significant impact on global health systems. Because little is known about the clinical characteristics and risk factors connected with COVID-19 severity in Sudanese patients, it is vital to summarize the clinical characteristics of COVID-19 patients and to investigate the risk factors linked to COVID-19 severity. Objectives: We aimed to assess the clinical characteristics of COVID-19 patients and look into risk factors associated with COVID-19 severity. Methods: This is a retrospective cross-sectional study that took place in two Isolation Centers in Wad Medani, Gezira State, Sudan. Four hundred and eighteen patients were included between May 2020 and May 2021. All COVID-19 patients over the age of 18 who were proven COVID-19 positive by nucleic acid testing or had characteristics suggestive of COVID-19 on a chest CT scan and had a complete medical record in the study period were included. Results: The participants in this study were 418 confirmed COVID-19 cases with a median age of 66.313 years. There were 279 men (66.7%) among the patients. The most prevalent comorbidities were hypertension (n = 195; 46.7%) and diabetes (n = 187; 44.7%). Fever (n = 303; 72.5%), cough (n = 278; 66.5%), and dyspnea (n = 256; 61.2%) were the most prevalent symptoms at the onset of COVID-19. The overall mortality rate (n = 148) was 35.4%. Patients with severe illness had a mortality rate of 42.3% (n = 118). Older age, anemia, neutrophilia, and lymphocytopenia, as well as higher glucose, HbA1c, and creatinine levels, were all linked to severe COVID-19, according to the chi-square test and analysis of variance analysis. Conclusion: Sixteen variables were found to be associated with COVID-19 severity. These patients are more prone to go through a serious infection and as a result have a greater death rate than those who do not have these characteristics.

Bilateral basal ganglia infarction and bilateral thalamic lesions in sudanese pediatric patient with COVID-19 and malaria co-infection, a case report.

COVID-19 is of uncommon diagnosis in pediatric with their presentation in much of time of a non-specific entity; here, we experienced the case of a 2-year-old female with malaria presented with fever, cough, rhinorrhea, hemoptysis, and convulsion diagnosed as COVID-19, complicated with encephalitis, received treatment, and improved over weeks.