Nile Valley University (NVU) or Wadi El-Neel University is a public university located in Khartoum, Sudan. It was founded in 1990.It is a member of the Federation of the Universities of the Islamic World and the Association of African Universities.
Ramadan fasting is a central religious practice observed by millions of Muslims worldwide, including individuals with diabetes. This expert consensus statement from the Arab Diabetes Forum aims to critically appraise the scientific validity and clinical utility of the International Diabetes Federation—Diabetes and Ramadan Alliance (IDF-DAR) risk stratification tool in the context of real-world Ramadan fasting. The IDF-DAR tool provides a structured framework for pre-Ramadan counseling, its scoring system being based on expert opinion rather than validated clinical outcomes. Observational evidence indicates that morbidity and mortality do not increase during Ramadan, even among high-risk individuals who choose to fast. Fasting has also been associated with favorable metabolic effects, including improved lipid profiles, modest weight reduction, enhanced insulin sensitivity, and potential neuroprotective and immunomodulatory benefits. Despite these findings, limited access to structured education and low attendance at pre-Ramadan clinics reduce the tool’s practical impact of current recommendations. This consensus emphasizes a patient-centered, culturally informed approach that respects autonomy and integrates individualized education and ongoing clinician-patient communication. A contextual re-evaluation of current risk stratification models is proposed to better align endocrine and metabolic guidance with real-world fasting practices and optimize diabetes care during Ramadan.
Background: Hypertension (HTN) remains a critical global health challenge, disproportionately affecting displaced populations in low-resource settings. In Sudan, the aftermath of the April 2023 conflict has displaced millions, exacerbating vulnerabilities such as limited healthcare access, psychosocial stress, and poor living conditions. Objective: This study aimed to determine the prevalence of HTN and its associated risk factors among internally displaced persons (IDPs) in Wadi Halfa, Northern Sudan. Methods: This is a cross-sectional study conducted in 2024 among 299 adult participants through convenience sampling. Data were collected through structured questionnaires and physical measurements (blood pressure, body mass index [BMI], waist circumference). Results: The study revealed a HTN prevalence of 21% (grades 1-3 combined), with significant associations observed with older age (53% of hypertensive participants aged 41-60 years, P < 0.001), marital status (94% married, P < 0.001), and obesity (mean BMI 28.9 versus. 23.5 in normotensive individuals, P < 0.001). Diabetes mellitus (DM) was strongly linked to HTN (16% comorbidity; P = 0.003), whereas lifestyle factors such as smoking and diet showed no significant correlation. Over half (51%) of participants were unemployed, and 57% reported interrupted access to healthcare. Conclusion: The study identified a high prevalence of HTN (21%) among IDPs in Wadi Halfa, Sudan, driven by demographic factors such as older age, marital status, and clinical risk factors like obesity and DM. These findings highlight the compounded burden of non-communicable diseases in conflict-affected populations, exacerbated by systemic challenges including disrupted healthcare access, psychosocial stressors, and inadequate infrastructure. Addressing these challenges requires urgent interventions to mitigate morbidity and mortality in vulnerable populations. In this conflict context, we recommend immediate healthcare system support as well as establishing targeted screening programs.
Abstract Antimicrobial resistance (AMR) is a worldwide health concern that compromises the successful treatment of a growing array of infectious diseases, particularly in low- and middle-income countries. AMR is exaggerated by the spread of antimicrobial resistance genes (ARGs) across humans, animals, and environmental reservoirs like water and soil. Hospital wastewater (HWW) is the main source of antimicrobial resistance in the environment. The current study used high throughput metagenomic nanopore sequencing to investigate the microbial abundance and ARGs associated with both HWW and tap water in five different hospitals in Cairo, Egypt. The bacterial community composition of the HWW microbiome identified 25 taxonomic families. The most abundant genera in HWW were Acinetobacter (6%) and Propioniciclav (5%) out of 101 unique genera while, the most abundant in tap water were Enterococcus (53%), Escherichia (15%), and Francisella (14%) out of 89 unique genera. Alpha diversity analysis revealed significantly greater microbial diversity in the HWW samples than in the tap water samples (P value > 0.05), moreover beta diversity analysis revealed a significant difference in the microbial community composition between the tap water and HWW samples (P value > 0.05) using Chao metric for richness estimation and Shannon metric for richness and evenness estimation. Total ARG analysis revealed absence of ARGs in tap water using the three databases, while comparable levels of ARGs were detected in HWW across the five hospitals. In total, 45, 28, and 28 ARG subtypes were identified in the HWW samples using ResFinder, CARD, and the NCBI AMRFinderPlus databases, respectively. The most abundant AMR mechanisms among the five hospitals were linked to the inhibition of protein synthesis. Using the ResFinder database, streptogramin resistance genes were most prevalent in Hospitals 1 and 5 (15% and 40%, respectively); using CARD, aminoglycoside, lincosamide, and macrolide resistance genes were most predominant (relative abundances 35–60%). Using NCBI AMRFinderPlus, streptomycin, tetracycline, and macrolide resistance genes were most prevalent (relative abundances 30.1–60%). Detection of plasmid replicons in HWW identified 39 different plasmid-associated replication genes via the PlasmidFinder database. The Col440l-1, colRNAI-1 and Col440ll-1 plasmid replicons were the most detected across the five hospitals with relative abundances of 16.6%, 10.9% and 9.6%, respectively. This study revealed different microbial communities among HWW and tap water in addition to the widespread occurrence of ARGs and AMR encoding plasmid replicons in the HWW in the five different hospitals in Cairo, Egypt indicating a significant risk associated with HWW, necessitating the implementation of preventative measures to avert their environmental diffusion. To our knowledge, this is one of the first Egyptian studies to apply Oxford Nanopore long-read metagenomic sequencing for simultaneous profiling of microbial communities and the resistome in HWW and tap water, using three ARG databases across five hospitals in two seasons.
BACKGROUND The Sudan war has severely disrupted healthcare services, particularly for patients with end-stage renal disease (ESRD) dependent on regular hemodialysis. Conflict-related displacement, damaged infrastructure, medication shortages, and financial hardship have compromised dialysis continuity and patient outcomes. This study assessed the impact of war-related displacement on dialysis care among Sudanese hemodialysis patients. METHODS This cross-sectional observational study included 101 displaced ESRD patients receiving maintenance hemodialysis. Data collection comprised demographic characteristics, causes of ESRD, dialysis access and adequacy, treatment interruptions, complications, medication availability, hospital admissions, and functional status before, during, and after the war. Comparisons of dialysis parameters and functional status before, during, and after the war were performed using Cochran’s Q test. RESULTS War-related displacement was associated with statistically significant worsening of dialysis care. Dialysis frequency decreased from two to 1.5 sessions per week, and session duration declined from four to three hours (both p<0.05). Patients missed a median of one dialysis session per week. Consequently, out-of-pocket payment for medications surged from 42 (41.6%) pre-war to 93 (92.1%) during the war and persisted at 89 (88.1% in the current period (p<0.0001). Erythropoietin use declined from 98 (97.1%) to 39 (38.6%) (both at p<0.001). Displacement was also associated with significantly increased complications, hospitalizations, reduced medication adherence, and marked fatigue (p < 0.05). CONCLUSION War-related displacement significantly reduced dialysis adequacy, medication access, and continuity of care, resulting in increased morbidity. Immediate humanitarian and health-system interventions are essential to prevent excess mortality among displaced hemodialysis patients.
Medical students face a significant burden of depressive symptoms and social isolation, particularly in conflict-affected regions like Sudan, where access to formal mental health services is severely restricted. While AI chatbots are increasingly adopted for academic and emotional assistance, their relationship with psychological outcomes in such unstable, resource-constrained environments remains poorly characterized. This study aimed to evaluate the association between conversational AI utilization, depressive symptoms, and social isolation among Sudanese medical students to guide evidence-based policy and the responsible development of digital support tools. A large-scale, cross-sectional survey was conducted between November 2025 and March 2026. Data were collected from 2,507 medical students using validated instruments, including the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Revised UCLA Loneliness Scale-6 (RULS-6) for social isolation. Structured questionnaires assessed sociodemographic characteristics, chatbot usage patterns, and perceived psychological benefits. Chatbot adoption was nearly universal, with 41.9
