Background: Cleft palate repair aims to restore palatal function while minimizing early complications that compromise healing and speech. Data from resource-limited settings remain limited. Methods: A retrospective cohort of consecutive patients undergoing primary palatoplasty at Soba Teaching Hospital, Khartoum, Sudan (between September 1, 2016 and March 31, 2017), with a 3-month follow-up, were included. Of the 70 screened procedures, 49 met inclusion criteria and were included in the analysis. Surgical technique (Bardach, Furlow, or von Langenbeck) and age at repair were considered. Outcomes considered were early wound dehiscence and/or oronasal fistula within 3 months; secondary outcomes included postoperative bleeding, respiratory obstruction, and flap necrosis. Analysis of absolute risks with 95% confidence intervals (CIs) and exploratory estimates of effects was performed. Results: Among 49 children (53.1% male; mean age, 44.1 ± 68.4 months; range, 6–324 months), dehiscence occurred in 6/49 (12.2%, 95% CI: 5.7 to 24.2) and fistula in 6/49 (12.2%, 95% CI: 5.7 to 24.2). Dehiscence varied by age group (peak 12–24 months: 29.4%) and by technique (Bardach 42.9%, Furlow 8.3%, von Langenbeck 6.7%). Fistula risk varied across cleft types (highest in unilateral cleft lip and palate [UCLP]) and techniques (0% with Bardach and Furlow vs 20.0% with von Langenbeck), with wide CIs due to the small number of events. No postoperative bleeding, airway obstruction, flap necrosis, or deaths were recorded (0/49; upper 95% CI: 7.3%). Conclusion: In this resource-limited setting, early complications occurred in approximately 1 in 8 children. Dehiscence appeared more common at 12–24 months and with Bardach; fistula showed center-specific heterogeneity, with no clear overall associations. Estimates are imprecise (small n, wide CIs) and susceptible to confounding by indication. Standardized perioperative protocols and earlier repair, where feasible, may reduce risk; prospective multicenter studies are warranted.
Background: Methylenetetrahydrofolate reductase (MTHFR) is a key enzyme in folate metabolism. Polymorphisms of the MTHFR gene, particularly C677T and A1298C, can reduce enzyme activity and lead to elevated homocysteine levels. This, in turn, may contribute to placental vascular disease and endothelial dysfunction, which are hallmark features of preeclampsia (PE). Methods: A case–control study was conducted at El Obeid Teaching Hospital in North Kordofan. Blood samples were collected from 100 women with PE and 120 age-matched healthy pregnant women as a control group, both were in the second half of pregnancy. DNA was extracted from EDTA-treated blood samples, and PCR–RFLP analysis was performed to detect the C677T and A1298C variants of the MTHFR gene. Results: The prevalence of the 677CC genotype was 89% in cases and 90.8% in controls. The 677TT mutation was observed in 1% of cases and was absent in the control group. The heterozygous 677CT genotype was present in 10% of cases and 9.1% of controls, with no statistically significant difference between the groups. For the A1298C polymorphism, the 1298AA genotype was found in 7% of cases and 3.3% of controls. The 1298CC mutation was detected in 2% of cases and was absent in controls. The heterozygous 1298AC genotype was observed in 91% of cases and 96.5% of controls, with no significant difference. Logistic regression analysis demonstrated no significant association between MTHFR C677T and A1298C polymorphisms, and the risk of PE (OR 1.33; 95% CI 0.57 to 3.08; P = 0.506 and OR 1.03; 95% CI 0.71 to 1.51; P = 0.865, respectively). Conclusion: MTHFR polymorphisms (C677T and A1298C) were not considered as genetic risk factors for the development of PE among Sudanese pregnant women in North Kordofan State.
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Background: Methicillin-resistant Staphylococcus aureus (MRSA) has been a significant clinical issue because of its resistance to common antimicrobial agents. Although nanocurcumin has been shown to have an antibacterial effect against MRSA, it is not yet well understood how it influences the dynamics of bacterial growth. This study aims to assess the impact of nanocurcumin on the kinetics of MRSA growth under continuous monitoring of optical density with particular dependence on the presence of mecA in the bacteria. Methods: Isolates of 50 S. aureus were obtained from clinical samples and tested on antimicrobial susceptibility. MRSA was confirmed molecularly by use of PCR which targeted the mecA gene. The efficacious concentrations of nanocurcumin were established by using predetermined MIC values to conduct an analysis on growth kinetics. MecA-positive MRSA isolates were subjected to 24-hour optical density to determine the growth dynamics in the presence of nanocurcumin. Results: The isolates were all identified as S. aureus, with 15 mecA-positive MRSA isolates exhibiting multidrug resistance but being sensitive to doxycycline and rifampicin. Nanocurcumin treatment led to a significant growth reduction starting from 4–6 hours. This resulted in a persistent negative growth rate of –0.012 ± 0.003 optical density/hour and a 90.6% reduction in total bacterial growth (AUC) compared to untreated controls. This implies a gradual decrease in bacterial viability, and not just growth inhibition. Conclusion: Nanocurcumin is fast and long-lasting in its ability to inhibit mecA-positive MRSA and highlights its strong potential in terms of addressing multidrug-resistant strains.
Background: The rise in armed conflict, which started in April 2023, has had a devastating impact on Sudan’s mental health system due to its existing structural vulnerabilities and has placed the population under significant mental health demands. Internally displaced people (IDP), students, the elderly, women, and children have been particularly impacted due to widespread displacement, destruction of health infrastructure, and disruption of service delivery. This narrative review set out to summarize available information on the disruption of the mental health system and the population’s mental health needs in Sudan post the April 2023 conflict. Methods: A narrative review methodology was utilized to combine heterogeneous evidence from peer-reviewed articles included in big databases and a small number of high-quality organizational reports. This synthesis came across three overall themes, including: (i) interruption in the mental health system and service capacity; (ii) mental health population needs among conflict-affected groups; and (iii) responses to mental health services, community response, and gaps in evidence. Longitudinal studies, intervention analyses, and geographical coverage, however, were found to be seriously lacking. Results: The results demonstrate the necessity of building mental health responses that are coordinated, and the key elements include the introduction of a communitybased approach, expanded service capacity, and enhanced surveillance systems. Conclusion: Mental health should be a priority within Sudan’s humanitarian response and health systems to address the long-term psychological impacts of the conflict and support recovery.
