Shivering is one of the most common complications of neuraxial blockade. Some patients find shivering sensation worse than surgical pain post-operatively. Therefore, both prevention and treatment of established shivering should be regarded as clinically relevant interventions during the preoperative period. This prospective experimental study was conducted at Wad Madani Maternity Teaching Hospital and aimed to measure the efficacy of pethidine when used for the treatment of postoperative shivering following spinal anesthesia during the period from November 2018 to February 2019. The sample size included of 40Patients within the American Society of Anesthesia type two physical statuses;25 mg pethidine diluted in 5 ml Normal saline-injected intra veins. All patients were monitored for temperature, heart rate, blood pressure, and oxygen saturation, these parameters were recorded preoperative, and post 10 minutes of operative, then after 10 minutes of pethidine dose administration. Data were analyzed by using a statistical package for social sciences (SPSS). The statistical results showed that there was a significant relationship between hypothermia and the presence of shivering. 90% of cases resolved to shivering, whereas 10% did not resolve, just 2.5% had Nausea and Vomiting and no side effects on the Respiratory and cardiac Systems. Based on those results the study concluded that: a small dose of pethidine 25 mg intra veins is very effective in resolving postoperative shivering with minimum side effects in the gastrointestinal tract and Good Cardiopulmonary stability. The study recommended that: warming tools should be available for patients to prevent heat loss, close monitoring of Patient's temperature intraoperative and in the recovery room, and use of 25mg Pethidine in the Presence of shivering intraoperative or post-spinal anesthesia.

Background: While most people follow social distancing and are avoiding contact with anyone displaying flu-like symptoms, still asymptomatic patients are having positive SAR COV 2 test can transfer disease to others, as well as the outcome of their disease sill not well understood. Objective: To assess the clinical course of asymptomatic COVID-19 patients who had a positive PCR test in multicenter. Methods: This was a prospective cohort multicenter study conducted in the study was conducted in Khartoum State COVID-19 Centres. Namely Alia Hospital, Fedail, and Ministry of Health Laboratories during the period from December 2020 to April 2021. Data was collected using a questionnaire from 98 patients who fulfilled the inclusion criteria. The questionnaire was filled with patients after taking informed consent. Results: The mean age was 49±7.3 years. Males were 58(59.2%) and females were 40(40.8%). The male to female ratio was 1.5:1. The frequency of symptomatic patients' COVID-19 positive test results experience symptoms was 80(81.6%), while the frequency of asymptomatic patients was 18(18.4%). The time and period of appearance of manifestations among COVID 19 patients, the study indicated that among symptomatic patients after PCR test, the moment of appearance of symptoms was 1 – 7 days in 76(95%) and 8 – 14 days after test in 4(5%). After 28 days follow up the outcome of the patients was recovery 76(76.6%), remain Asymptomatic 18(18.4%), and remain symptomatic 4(4.0%). Conclusion: The study demonstrated that the appearance of symptoms before and after the PCR test was significantly affected by chronic diseases as well as chronic medications in use (P. value <0.05).

Over the last decade, Aryl Hydrocarbon Receptor (AHR) dragged the research community’s attention due to the associated benefits in physiology and pathology. In this study, the probable role of AHR in cancer development is discussed. The ABCG2 gene that regulates uric acid metabolism is controlled by AHR. The study noticed that the failure of AHR control over ABCG2 leads to the accumulation of uric acid, reduction of vitamin D, and hormonal imbalances that are sequentially associated with several types of cancer. Furthermore, the location of AHR in the cytoplasm and its role in the regulation of the development and differentiation of blood cells, makes it impacts on overall cells of the body, while cancer genes can be transmitted through AHR receptors in the placenta to the offspring. Overtiredness of AHR by aging, microbial, chemical, or other environmental factors escalates the risk of cancer cell growth. Consequently, immune system dysfunction is facilitated by metastasis. Meanwhile, the Tryptophan catabolism indicates the exhaustion of AHR. However, this hypothesis lacks experimental exploration for further validation.

Myecetoma is one of the neglected tropical diseases, most prevalent in tropical and subtropical regions in the area known as myecetoma belt. It is caused either by fungi (eumycetes) or bacteria (actinomycetes). We suggest that, through their strong and stable, mycotoxin inhibits pain and aryl hydrocarbon receptor actions and promotes IL-17 release. Furthermore, it affects Catechol-O-methyltransferase (COMT), which is responsible for male sexual orientation and this explains the predominance of myecetoma among men and we suggest that the size of lesion is related to the strength of COMT activity in male patients. Due to the absence of laboratory facilities, we are not able to achieve more than these suggestions, so experimental studies are recommended.

Background: Malaria is a major public health problem throughout human history, particularly in the tropical and subtropical countries. Primaquine, introduced in 1950, for preventing relapse and sterilizes infectious sexual plasmodia. Methods: A retrospective study was performed for 610 patients (250 were male and 360 were female), (all ages) to study the efficacy of Primaquine in the treatment of falciparum malaria after receiving this drug for five days. Results: Five hundred and ninety three patients (97.2 %) were completely recovered from malaria within 3 to 5 days after receiving Primaquine tablets. Conclusion: In our opinion Primaquine should become the first line as antimalarial drug soon later for uncomplicated malaria, because of its high efficiency against infections with Plasmodiumfalciparum and P.vivax active stages.

Aim: Pulmonary hypertension (PH) is a progressive pulmonary vascular disease characterized by pulmonary artery remodeling and vasoconstriction resulting in elevated pulmonary arterial pressure and consequent right heart failure. In this study, we aimed to present our single center clinical experience with these patients. Method: 331 patients who were followed up in our center with the diagnosis of pulmonary arterial hypertension between 2013-2021 were evaluated by retrospective analysis method. Results: The mean age of the patients was 54.6, mean sPAB value was 75.4 mmHg and the mean follow-up period of the patients was recorded as 44.9 months. It was determined that 68.9% of them were female. When the etiological diagnoses were evaluated in order of frequency; congenital heart disease, chronic thromboembolic pulmonary hypertension (CTEPH), idiopathic pulmonary arterial hypertension (IPAH), collagen tissue disease, disproportionate pulmonary hypertension (group 2, group 3) and rare cases (pulmonary veno-occlusive disease (PVOD), portal hypertension (PoHT)). When the survival analysis is evaluated, the risk of mortality increases 1.021 times as the age increases. Men have a 1,863 times higher risk of mortality than women. The mortality risk of those with a congenital diagnosis is 0.36 times less than those with a diagnosis of IPAH. Negative correlation was found between functional class of patients and mortality (p<0.005). The risk of mortality increases 1.016 times as the SPAB increases. Conclusion: “Pulmonary hypertension is a disease with high mortality and includes different disease groups”. The follow-up of these patients in PAH centers and the use of special medications affect mortality rates.

Abstract: Numerous medications are now approved to treat and relieve symptoms related to Alzheimer's Disease (A.D.). Most of these drugs regulate the neurotransmitters, thereby modulating the transmission of messages between neurons. However, these drugs are helpful in the reduction of A.D. symptoms associated with particular behavioral problems but are unable to change the underlying pathophysiological process accounting for the disease. In addition, their effectiveness is limited for a small group of people and thus may be helpful for a limited period. Therefore, the scientists are investigating the possible strategies for the symptomatic treatment and finding out the ways to hold back or prevent the disease. Drug development and assessment for newer and better drugs as well as treatment methodologies are caring out by the scientists in ongoing clinical trials. This study has been carried out to accumulate the different treatment strategies, including drug therapies intended for various targets such as loss of specific neurotransmitters & synapses, cerebrovascular function, neurofibrillary tangles & beta-amyloid plaques, as well as other nondrug approaches.