University of Gezira

Egypt has recently been certified as malaria-free. To sustain this status, the Egyptian Ministry of Health has implemented a policy of centralised malaria treatment at specialised hospitals, provided free of charge to all populations regardless of migrant status. This study examines migrants' malaria care-seeking experiences, the factors influencing their choices, and strategies to improve access. A qualitative study was conducted in Cairo using semi-structured interviews, inviting adult migrants from malaria-endemic countries and with prior malaria experience. Participants were recruited through purposive and convenience sampling. Data were collected in Arabic, transcribed, translated, and analysed thematically. We recruited 21 individuals, all Sudanese; 90.5% were female. Five participants (24%) developed malaria symptoms immediately upon arrival in Egypt; others developed symptoms within six months. Three themes emerged from the analysis: "Malaria-specific healthcare practices," "Determinants of healthcare-seeking behaviour," and "Recommendations." Although participants recognised the severity of malaria and the need for treatment, 19 (90.5%) initially relied on traditional remedies or self-medication without malaria testing. Factors influencing healthcare-seeking behaviour included, at the patient level, a lack of trust in healthcare professionals, reluctance to disclose a malaria diagnosis due to stigma, fears of quarantine, concerns about adverse drug effects, and exposure to negative rumours and misconceptions about treatment. Factors within the healthcare system encompassed malaria services' affordability, accessibility, and perceived quality. Sudanese migrants' malaria care-seeking behaviours are influenced by multiple personal and systemic factors. Improving access requires targeted health education to address misconceptions, raise awareness, and build trust in the healthcare system.

<title>Abstract</title> <bold>Background:</bold> Community pharmacies (CPs) in Sudan are accessible and cost-effective points of healthcare. However, Pharmaceutical Care Services (PhCS) has not been widely adopted. So far, adoption depends critically on resolving challenges and effectively utilizing the available opportunities. <bold>Objective:</bold> To assess the challenges and opportunities for pharmaceutical care adoption in private community pharmacies(CPhs), Wad-Madani, Gezira State, Sudan. <bold>Methods:</bold> This cross-sectional study was conducted from December 2019 to August 2020, involving 120 community pharmacists. A pre-tested, self-administered, structured questionnaire was used for data collection. The Statistical Package for the Social Sciences (version 26) was used for the analysis of categorical data variables. The p-value (α = 0.05) is the cutoff point for determining the significance of the results. <bold>Results:</bold> The response rate among participants was 87.1%. The demographic characteristics showed younger age dominance (82.5% aged ≤ 40), with 63.3% females, less experience (&lt; 20 years, 92.5%), and most holding a B.Pharm degree (91.7%). Over half of pharmacists (52.5%) engaged in multitasking roles, including dispensing, counseling, handling money, and managerial activities, often without a separate counseling area. Awareness regarding PhCS was high (81%). However, the main barriers included 40% as insufficient continuous professional development (CPD) and 31.7% due to public perceptions. In comparison, the top supporting factor was the presence of organized staff members (55.8%). Pharmacists prioritized CPD (61.7%) as a means of supporting PhCS adoption. Overall, the observed difference between pharmacy groups was statistically insignificant for all variables (X² and Fisher's Exact test, p-values &gt; 0.05), indicating uniformity among community pharmacists. <bold>Conclusions:</bold> The demographic profile presents both opportunities and challenges. High awareness suggests rich ground for interventions. Interestingly, systemic barriers and discouraging factors can be overcome through coordinated strategies that involve education reform, regulatory frameworks, infrastructure design, and workforce planning. Results are essential for transforming community pharmacy practice into effective models of pharmaceutical care services.

This study aims to examine the war damages in Sudan from two complementary perspectives: the fundamental jurisprudential perspective, based on the texts of Islamic law and its objectives to protect life, property, and infrastructure; and an analytical legal perspective, based on Sudanese national legislation and relevant international agreements. The problem with the research lies in the absence of a comprehensive approach that balances the legal reference and the legal framework for addressing the damages caused by wars, as well as the weak practical implementation of the laws in force in Sudan and ensuring compensation for those affected. The methodology of the study is based on a descriptive-analytical approach, in addition to a comparative approach between Islamic jurisprudence and international law, with an analysis of cases from the Sudanese reality as an applied accounting of damages. The most important findings of the study are: first, there is agreement between Islamic jurisprudence and international law on prohibiting attacks on lives and property in the context of conflict; second, there is a significant gap between the legal frameworks adopted and the actual reality in Sudan in terms of implementation and compensation; third, the study emphasizes the importance of transitional justice and national reconciliation as mechanisms for rebuilding society and promoting social peace.

Pressure injuries remain a significant and largely preventable cause of morbidity among hospitalized patients. Accurate and complete risk assessment using validated tools such as the Braden Scale is fundamental to effective prevention; however, documentation practices are often inconsistent, particularly in resource-limited settings. To evaluate the completeness of Braden Scale documentation in the Internal Medicine Department at Dongola Specialized Hospital and to assess the impact of a targeted quality-improvement intervention through a closed-loop clinical audit. A prospective closed-loop clinical audit was conducted over two cycles, each reviewing 51 patient records. Baseline documentation practices (Cycle 1) were assessed against predefined standards derived from international pressure-injury prevention guidelines. Following a structured two-month intervention comprising staff education, reinforcement of documentation expectations, and introduction of a standardized Braden documentation form, a second audit cycle (Cycle 2) was performed using identical criteria. Documentation completeness was analyzed using descriptive statistics, and differences between cycles were assessed using chi-square tests. At baseline, none of the Braden subscale scores, total scores, risk levels, or preventive actions were documented. Following the intervention, documentation of all six Braden subscales improved to near-universal completion (96.4-100%). Documentation of total Braden score, risk level, and preventive actions increased to 89.1%, 83.6%, and 89.1%, respectively (all p < 0.001). Significant improvements were also observed in consultant identification and bed number documentation. Conversely, completion rates for certain demographic fields, particularly hospital number and admission date, declined in Cycle 2. This audit demonstrates that targeted education and standardized documentation tools can lead to substantial and statistically significant improvements in Braden Scale documentation. While clinical risk assessment practices improved markedly, persistent gaps in administrative documentation highlight the need for sustained monitoring and system-level reinforcement. Closed-loop clinical audits represent an effective strategy for strengthening pressure-injury risk assessment practices in hospital settings.

BackgroundChronic kidney disease (CKD) and dementia are major causes of morbidity and mortality among older adults and frequently coexist due to shared vascular and metabolic risk factors. Despite their clinical importance, national mortality trends for these conditions remain underexplored. This study aimed to examine temporal and demographic patterns of mortality among individuals with coexisting CKD and dementia in the United States from 1999 to 2020.MethodsIn this retrospective, population-based study, mortality data for adults aged ≥25 years were extracted from the Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research database. Deaths listing both CKD [International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10 N18.x)] and dementia (ICD-10 F01.x, F03, G30.x) as causes were included. Age-adjusted mortality rates (AAMRs) per 100 000 were calculated using the 2000 U.S. standard population. Temporal trends were analyzed using Joinpoint regression to estimate annual percent change and average annual percent change (AAPC) with P < 0.05 considered significant. Subgroup analyses were stratified by gender, race/ethnicity, age, region, and urbanization.ResultsBetween 1999 and 2020, 170 375 deaths were attributed to CKD and dementia. The overall AAMR increased from 1.03 to 5.92 per 100 000 (AAPC 7.41%). Mortality increased significantly across both genders, older adults, and all census regions, peaking in 2012, briefly declining between 2012 and 2015, then rising during 2015 to 2020. Males had higher mortality (AAMR 4.24) than females (3.16). Non-Hispanic Black individuals exhibited the highest rate (6.20), followed by non-Hispanic White (3.35) and Hispanic (3.09) populations. The Midwest showed the highest regional burden (AAMR 3.90), while rural counties recorded greater mortality (3.89) than urban areas (3.49).ConclusionThe increasing mortality trends show a close relationship between CKD and dementia. Thus, improving early diagnosis, ensuring equal access to care, and providing a holistic treatment approach targeting both the organs is key to enhancing optimal patient care and consequently reducing mortality.

The accurate authentication of medicinal plants is critical for ensuring the safety and efficacy of herbal products. This study provides a comprehensive morphoanatomical characterization of six medicinally important Solanaceae species from Sudan: Datura innoxia, Physalis angulata, Solanum dubium, Solanum incanum, Solanum nigrum, and Withania somnifera. Fresh leaf samples were collected from their natural habitats in Khartoum and eastern Sudan. Transverse sections and epidermal peels were examined using light microscopy with digital imaging. Distinct anatomical markers were identified, including epidermal cell wall patterns, stomatal types (anisocytic, paracytic, anomocytic), trichome morphology (glandular, non-glandular, stellate), calcium oxalate crystal forms (druses, crystal sand), and mesophyll organization. A diagnostic dichotomous key was developed based on these micromorphological traits. Notably, P.angulata displayed undifferentiated mesophyll with sinuous anticlinal walls, while W.somnifera exhibited stellate trichomes and two types of calcium oxalate crystals. S. nigrum showed paracytic stomata and unicellular trichomes, whereas D. innoxia presented glandular trichomes and druse crystals. These findings provide reliable, microscopy-based tools for authenticating fragmented or powdered herbal material, combating adulteration in the traditional medicine trade. The study bridges a significant gap in the botanical documentation of Sudanese medicinal flora and supports quality control in pharmacognosy, conservation planning, and ethnobotanical research.