The Alzaiem Alazhari University (Arabic: جامعة الزعيم الأزهري) located in Khartoum North, Sudan. It was established in 1993 in memory of Ismail al-Azhari.It is a member of the Federation of the Universities of the Islamic World.
Glioblastoma (GBM) remains the most common and lethal primary central nervous system tumor, with a median survival of only 14.6 months under standard care. The tumor’s characteristic "Warburg effect"—a dependency on aerobic glycolysis for energy—creates a metabolic vulnerability. This review evaluates the efficacy and safety of the ketogenic diet (KD) as an adjunctive metabolic therapy aimed at exploiting this glucose dependency. This PRISMA-compliant systematic review updates clinical evidence by synthesizing data from databases from 2000 to September 2025. We searched PubMed, Embase, Cochrane, and Web of science for human studies assessing the ketogenic diet (KD) in glioblastoma and high-grade gliomas. Primary outcomes included overall survival (OS), progression-free survival (PFS), feasibility, and adverse events. Study quality was assessed using Joanna Briggs Institute tools. Prospero registration: CRD420251232650. Forty-one studies were included, ranging from randomized trials to case series and abstracts, utilizing interventions such as the classic 4:1 ketogenic diet, Modified Atkins Diet, and calorie restriction. Adherence was high (> 75
Background: Cholera remains a significant public health challenge, particularly affecting vulnerable populations such as internally displaced persons (IDPs). This study assessed knowledge regarding cholera among IDPs in Kassala, Sudan, a region experiencing a recent outbreak. Methods: This analytical cross-sectional study included 389 IDPs aged 5-65 years in Kassala between October and December 2024. Data were collected using a digital and paper-based Arabic questionnaire, with stratified random sampling across different education levels. The questionnaire assessed sociodemographic characteristics, knowledge of cholera causes, symptoms, prevention, and attitudes toward oral cholera vaccination. Data were analyzed using SPSS v28.0.0, including descriptive statistics and chi-square tests. Results: About 38.8% were aged 5-18, and 62.5% were male. Most were displaced from Khartoum (51.2%), lived in camps (71.7%), lacked stable income (67.6%), and relied on public faucets (67.9%). High awareness of causes was observed: over 93% identified poor hygiene, contaminated water/food, and open defecation (p < 0.001). Key symptoms such as watery diarrhoea (97.7%), vomiting (90%), and severe dehydration (85.9%) were widely recognized. Preventive measures like handwashing (99.2%), water treatment (97.9%), and vaccination (92.8%) were well known (p < 0.001). Conclusion: IDPs in Kassala show strong cholera knowledge. However, improving water, sanitation, and income stability is essential for effective prevention.
Familial Mediterranean fever (FMF) is an autoinflammatory condition caused by a single-gene mutation, inherited in an autosomal recessive pattern, and characterized by recurrent episodes of self-limited inflammation. Studies suggest that vitamin D levels may be lower in FMF patients, but evidence remains unclear. This study aims to assess the relationship between FMF and serum vitamin D levels. We followed PRISMA guidelines and registered the protocol in PROSPERO (CRD420261299635). We searched PubMed, Scopus, and Web of Science up to December 2025 for observational studies comparing FMF patients with healthy controls. Our main outcomes were serum 25-hydroxyvitamin D, parathyroid hormone (PTH), and C-reactive protein (CRP). We combined the data as mean differences using a random-effects model. Ten studies (563 FMF patients) were included. The pooled analysis showed a significant drop in vitamin D levels in FMF patients compared to healthy controls. However, there was high heterogeneity between studies (I2 = 89
Background: Robotic platforms have slightly impacted minimally invasive surgery, although the extent of their superiority over conventional laparoscopy for left colectomy remains ambiguous. Robotic-assisted left colectomy (RLC) is increasingly utilized for the management of colorectal illnesses; nonetheless, there remains debate regarding its superiority over laparoscopic left colectomy (LLC). This meta-analysis integrates data from 24 studies, including over 70 000 people, to provide a comprehensive overview of the outcome disparities pre- and post-surgery. Methods: We conducted a comprehensive search of PubMed, Scopus, Web of Science, and Cochrane from 2004 to April 2025 to identify studies comparing RLC vs. LLC in adults. We utilized RevMan 5.4 to amalgamate the data. We employed random-effects models to determine the risk ratios (RRs) and mean differences (MDs). Sensitivity analysis was conducted to evaluate the robustness of the results amid increased heterogeneity. Results: A total of 24 investigations were conducted. RLC significantly reduced the likelihood of requiring open surgery (RR 0.53), experiencing postoperative complications (RR 0.87), encountering an anastomotic leak (RR 0.84), developing a superficial wound infection (RR 0.79), and necessitating additional surgery. The results were significantly more robust when high-variance trials were excluded from the sensitivity analysis. The duration of the procedure was significantly extended with RLC (MD + 40 minutes), although there were no changes in mortality (RR 1.26; P = 0.07) or hemorrhage (RR 1.00). No significant changes were observed in Clavien–Dindo >2 complications or stoma formation. Subgroup analysis was done for more robust findings. The asymmetry observed in the funnel plot suggests the potential existence of publication bias for certain outcomes. Conclusion: RLC demonstrates modest yet clinically significant advantages compared to LLC, particularly in reducing the incidence of surgical conversions and sequelae. These findings advocate for its application in a select group of patients, considering the duration of the treatment and the institution’s resources.
Introduction:Diabetic nephropathy (DN), a major microvascular complication of diabetes, is increasingly implicated in systemic vascular dysfunction and may contribute to the pathogenesis of Alzheimer's disease (AD). Microvascular injury is a recognized mechanism in AD, and DN-related damage may raise the risk of cognitive decline. Methods:Following the PRISMA 2020 guidelines, we searched PubMed, Scopus, and the Cochrane Library (2000-2025) for studies on DN-related vascular damage and cognitive outcomes. Quality was assessed using the Newcastle-Ottawa Scale and the AXIS tool. Results:Of 275 records, nine studies were included (cross-sectional and longitudinal, with up to 37.5 years of follow-up). DN was measured via eGFR, albuminuria, the fibrinogen-to-albumin ratio, or ICD codes; cognition via assessed using amyloid PET, neurocognitive tests, or registry data. All studies found that impaired kidney function was associated with a greater risk of AD or cognitive decline. Conclusion:Available evidence links DN-related microvascular damage to a higher risk of AD, suggesting a kidney-brain axis. However, causality remains uncertain and requires longitudinal and mechanistic studies to clarify these pathways.
