Background: The impact of cancer extends beyond patients and consumes their families. Family members are widely recognized as informal caregivers. The economic burden on family caregivers is increased with new treatments, prolonged survival, and reduced stay in the acute care setting. This is especially true in African countries where family bonds are sacred and health system is fragile that they need to pay out of pocket for care. The aim of this study is to estimate the perceived caregivers’ economic burden in the subsequent aspects: financial strain, inability to make ends meet, not enough money for necessities, and economic adjustments/cutbacks. Method: This study was a quantitative, descriptive cross-sectional study conducted at Khartoum oncology hospital. Included 143 caregivers of cancer patients. Data were collected through face-to-face interviews using the socio-demographic Questionnaire and Economic Hardship Questionnaire (EHQ). Results: One hundred forty-three cancer patients and their caregivers were included. 56.6% of patients were females, and about 32.2% were aged 51–65 years. The most common cancer types were breast cancer and leukemia. Roughly 33% of patients had stage IV cancer on presentation, and about 53.9% received chemotherapy. Unlike cancer patients, (47.6%) of family caregivers were aged 18–34 years, yet they were mainly females (54.4%). Most of them (34.3%) were unemployed, with a mean monthly gross income of 53.3 dollars, while the mean household monthly gross income was 113.0 dollars. The mean score of the economic hardship scale was 35.8 out of 64. Most of the caregivers experience no difficulties affording necessities. However, they experience difficulties with medical and leisure activities. There was no significant association between caregiver economic hardship and cancer patient characteristics (patients' age, cancer stage, and treatment type). However, there was a significant association between caregivers' economic hardships and their gender, marital status, educational level, occupation, caregiver monthly gross income, and household monthly gross income. Conclusion: The study findings suggest a moderate financial burden among cancer caregivers. The predicting factors include being single, a student, male, of higher educational level, and lower income. Financial difficulties are associated with maladaptive behavior and should come to light.

This article reported a case of intestinal tuberculosis (ITB)in a young patient. ITB could mimic many other diseases such as inflammatory bowel diseases (Crohn’s disease), abdominal lymphoma, and others which make it difficult to differentiate; hence, many ITB patients could get mis‐diagnosed and suffer wrong treatment consequences.

Introduction: Burns are among the most agonizing injuries encountered in the clinical setting. Protocols for effective management of burn pain vary and mostly rely on opioids, a drug class well-known for dependence and adverse effects from misuse. Lidocaine, the most commonly used local anesthetic, has shown potential to reduce the amount of opioids required. This study aims to assess the effectiveness of lidocaine infusion in reducing opioid use in patients with burn injuries. Methods: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of the electronic databases was carried out using the keywords “lidocaine,” “lignocaine,” “xylocaine,” “burn,” and “analgesia.” Eligible studies were randomized controlled trials (RCTs) from peer-reviewed journals or registries. Two independent reviewers conducted the screening. The Cochrane Risk of Bias-2 tool was used to assess the quality of the included studies. Meta-analysis was conducted using Revman software. Results: We included four RCTs with 152 burn patients with the total body surface area burned ranging from 3% to 68%. Morphine use had a standardized mean difference (SMD) of −0.47 (−1.18 to 0.24), which was not significant (P = 0.19). The changes in pain score were not significant [SMD = −0.01, confidence interval (CI) = (−0.37; 0.34), P = 0.94]. Nausea had an Risk ratio of 1.06 [CI = (0.80; 1.40), P = 0.700]. No serious adverse event was reported. Conclusion: Our findings were inconclusive about the safety and effectiveness of lidocaine as an adjunct in the analgesia of burns and reducing the required opioid dosage. Large-scale clinical trials are needed.

Background: As of December 2021, the World Health Organization (WHO) reports that Coronavirus disease 2019 (COVID-19) led to about 5,403,662 deaths. While COVID-19 has resulted in millions of deaths worldwide to date, vaccination remains the mainstay of infection control. AZD1222 (AstraZeneca vaccine) was distributed in Sudan by the COVID-19 Vaccines Global Access facility in March 2021. It was added to the emergency use list by WHO in the middle of February 2021. However, vaccine safety among patients with autoimmune diseases, such as myasthenia gravis (MG), is yet to be established. MG is a relatively rare illness that could result in life-threatening complications. Myasthenic crisis is considered the most serious complication of MG that can lead to death due to aspiration and respiratory failure. Plasma exchange (PLEX), Immunoadsorption (IA), and intravenous Immunoglobulin (IVIG) are the first-line treatment for myasthenic crisis. It is proven that cortisone has a positive effect when used as add-on therapy with PLEX/IA and IVIG. The case: We report the case of a 37-year-old Sudanese female who presented to the emergency room with an exacerbation of her previously well-controlled MG following her second dose of AZD1222 vaccination. The exacerbation symptoms at time of presentation were severe generalized body weakness that increasing overtime and shortness of breath. Computerized tomography of the chest was performed, and it revealed no evidence of COVID-19. Management at the ER started with rehydration and IV methylprednisolone 1g, followed by IV hydrocortisone 200mg. She continued to deteriorate and was admitted to the intensive care unit where she was intubated and placed on a mechanical ventilator. IVIG was requested but couldn't be obtained due to the low-income setting, and fourteen days after admission patient died due to circulatory collapse. Our study aims to present an MG case with features of MG exacerbation following the administration of the second dose of AZD1222. Conclusion: Little is known about the effect of different COVID-19 vaccines on subgroups of patients with autoimmune diseases like MG. Although the safety profile of AZD1222 is generally reassuring, people with severe underlying diseases were excluded from trials. Therefore, more efforts and experimental studies may be needed, with closer vigilance in MG patients. It has not been elucidated how the COVID-19 vaccine might provoke autoimmunity, but several theories have been proposed. Molecular mimicry theory can explain how the genetic material of a virus could provoke autoimmunity, it describes the cross-reactivity of antibodies produced against proteins that are encoded by viral genetic material with the proteins located at the post-synaptic membrane. There is a debate about whether vaccine benefit outweighs the risk in MG patients or not. However, we believed that MG patients should be informed about the benefit and risks of COVID-19 vaccination.

Background: Vaccination remains the mainstay of strategy for prevention of Coronavirus Disease-2019 (COVID-19). AZD1222 (AstraZeneca vaccine) was distributed in Sudan by the COVID-19 Vaccines Global Access facility in March 2021. It was added to the emergency use list by the WHO in mid-February 2021. However, vaccine safety among patients with autoimmune diseases, such as myasthenia gravis (MG), is yet to be established. MG is a relatively rare illness that could result in life-threatening complications. Myasthenic crisis is considered the most serious complication of MG that can lead to death due to aspiration and respiratory failure. The case: We report the case of a 37-year-old Sudanese female who presented to the emergency room with an exacerbation of her normally well-controlled MG following her second dose of AZD1222 vaccination. She continued to deteriorate and was admitted to the intensive care unit, where she was intubated and placed on a mechanical ventilator. The low-income setting was a major barrier in obtaining intravenous immunoglobulin until the patient died. Our study aims to present an MG case with features of MG exacerbation following administration of a second dose of AZD1222. Conclusion: Little is known about the effect of different COVID-19 vaccines on subgroups of patients with autoimmune diseases like MG. In our case, an exacerbation of MG may have been precipitated by the COVID-19 AstraZeneca vaccine. Therefore, more efforts and experimental studies may be needed, with closer vigilance in MG patients

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) remains a significant global public health challenge, with the African region bearing the highest burden. In Sudan, rising HIV incidence is exacerbated by widespread poverty, limited awareness, and ongoing civil conflict. Health science students play a crucial role in HIV prevention and management, making their knowledge and education essential. This study aimed to assess the knowledge of Sudanese health science students regarding HIV/AIDS transmission, infection control, sources of information, and the need for further education. A cross-sectional study was conducted from 8 Sudanese universities and included 1463 health science students from various faculties (Medicine, Dentistry, Pharmacy, Nursing, and Laboratory Sciences) in Sudan during the period from July to October 2024. Data were collected via an online questionnaire and analyzed using descriptive statistics and chi-square tests to identify knowledge gaps and educational needs. The majority of participants (1059; 72%) were above 21 years old, with a female predominance (1015; 69%). Academic lectures (616; 42.1%) and the internet (524; 35.8%) were the primary sources of HIV/AIDS knowledge. However, significant gaps were identified, with 939 (64%) students expressing a need for further education, particularly in clinical management (1231; 84%) and referral guidelines (1102; 75%). Commonly identified high-risk groups included healthcare workers (1048; 71.6%) and barbers (1039; 71%). Barriers to HIV prevention included socioeconomic factors (932; 63%) and limited healthcare facilities (789; 53%). There is an urgent need to enhance HIV education among Sudanese health science students. Integrating structured HIV/AIDS training into medical curricula and expanding public health awareness initiatives could improve knowledge, reduce stigma, and ultimately strengthen HIV prevention and management efforts in Sudan.