Lower lung field tuberculosis (LLFTB) is an uncommon presentation of pulmonary tuberculosis and is often misdiagnosed as bacterial pneumonia or other lower respiratory tract infections. Its atypical radiographic pattern and transient response to empirical antibiotics can delay definitive diagnosis. We report the case of a 50-year-old male who presented with recurrent episodes of acute febrile respiratory illness, each separated by a two-week symptom-free interval. The patient required hospitalization on three occasions. Each episode showed partial remission with empirical antibiotic therapy, but symptoms recurred after antibiotic withdrawal. Chest radiography demonstrated infiltrates confined to the lower lung fields. HRCT (high resolution computerised tomography) imaging’s documented nodular infiltrates in right middle and lower lobe with mild pleural effusion. Given the recurrent nature and incomplete resolution, flexible bronchoscopy was performed as a point-of-care diagnostic tool, revealing endobronchial changes suggestive of tuberculosis and yielding bronchial washings positive for Mycobacterium tuberculosis on GeneXpert MTB/RIF assay. The patient was initiated on standard first-line anti-tubercular therapy with marked clinical and radiological improvement, and no further relapses over a 6-month follow-up. LLFTB can mimic recurrent bacterial pneumonia. Early bronchoscopy at the point of care facilitates timely diagnosis and initiation of specific therapy, preventing repeated hospitalizations and morbidity.

Background: Pulmonary tuberculosis (TB) continues to be a major global health problem, with post-tuberculosis lung disease (PTLD) emerging as an underrecognized sequela. Among its various manifestations, “destroyed lung” represents a progressive, debilitating outcome characterized by irreversible structural damage, recurrent infections, and significant impairment of quality of life. Despite successful completion of anti-tuberculosis therapy (ATT), patients often suffer long-term pulmonary morbidity. This case series highlights two patients with advanced PTLD presenting as destroyed lung, emphasizing the natural history, diagnostic challenges, and therapeutic outcomes. Case Presentation: The first case involves a 48-year-old male with a history of delayed TB diagnosis for three years, during which he was empirically treated for pneumonia, typhoid, and jaundice by various practitioners. Eventually, he was diagnosed with pulmonary TB and treated for eight months at a government center, with treatment deemed successful. However, after eight years of treatment completion, he presented to our center with recurrent respiratory symptoms. Bronchoscopy revealed a necrotic mucosal lumen with suppurative secretions in the left main bronchus extending into both upper and lower divisions. The bronchial anatomy was markedly distorted with dilated, ectatic bronchi. Bronchoalveolar lavage (BAL) cultures demonstrated colonization with Pseudomonas aeruginosa and Klebsiella pneumoniae. BAL GeneXpert MTB/RIF was negative, excluding active TB. He was managed with meropenem, amikacin, nebulized bronchodilators, and supportive care, showing marked clinical improvement after 14 days. The second case is a 51-year-old male with a delayed diagnosis of TB for two years. He too had initially been misdiagnosed and treated empirically for non-specific febrile illnesses. Eventually, he completed one year of ATT at a government center and was declared cured. Ten years later, he presented with persistent and recurrent pulmonary symptoms. Bronchoscopic evaluation revealed necrotic mucosa with purulent secretions in the right main bronchus, involving upper, middle, and lower divisions. The bronchial tree was distorted with extensive ectatic changes. BAL culture grew Pseudomonas aeruginosa and Klebsiella pneumoniae, while GeneXpert MTB/RIF was negative. He was treated with the same regimen as the first case and demonstrated a favorable outcome after two weeks of therapy. Discussion: Both patients highlight the long-term sequelae of delayed TB diagnosis and management. Even after microbiological cure, chronic structural lung damage predisposed them to persistent colonization with pathogenic organisms, recurrent infections, and functional impairment. These cases underline that destroyed lung syndrome is largely preventable with early recognition of TB, timely initiation of ATT, and structured follow-up care. Importantly, both cases reinforce that post-tuberculosis sequelae require comprehensive management beyond TB treatment completion, integrating bronchodilator therapy, infection control, and long-term pulmonary rehabilitation. Conclusion: Destroyed lung as a PTLD manifestation represents the culmination of delayed diagnosis and chronic lung injury rather than treatment failure or reactivation. Early detection, timely treatment, and structured long-term surveillance could prevent this disabling outcome. These cases emphasize the urgent need for public health strategies addressing PTLD to reduce the burden of preventable chronic respiratory morbidity.

Students' academic performance, in Internet era with increasing misuse of social media interfere with study habits. This study explored the effect of social media on academic performance among medical students, in three (3) River Nile State Universities in Northern Sudan. It was cross sectional study conducted on three hundred and eighty (380) medical students from April to October 2024. Participant’s students from Elsheikh Abdallah Elbadri University (EAEU) representing the largest portion (40.5%) Most students (63.4%) were aged (20 to 25) years with females comprising (57.1%) of participants. Nearly all students (96.6%) used social media primarily for non-academic purposes, and (58.9%) spent over four (4) hours daily on these non- academic sites. The majority reported that social media negatively impacted their academic Performance (62.4%) and affected their sleep (54.7%). About (75.8%) had implemented strategies to minimize social media effects on their academic and personal lives such as setting time limits or deleting certain applications.

Background: Peptic ulcer disease significantly impacts the healthcare system and remains a considerable cause of patient morbidity and mortality, leading to numerous psychosocial, emotional, and economic consequences. Gastrointestinal disorders significantly affect not only the health-related quality of life of those afflicted but also that of their relatives and families. Its onset at a young age disrupts a particularly active phase of human life. Objectives: This study aims to assess patients' awareness of lifestyle modifications for managing peptic ulcers. Methods: This study was a descriptive, cross-sectional, hospital-based research study conducted among patients with peptic ulcer disease (N = 50). Participants were selected from individuals attending the referral clinic of Elmek Nimir University Hospital, as well as patients who were admitted. The selection was carried out through convenience sampling. Before implementing the program, patients' knowledge was assessed using a structured, standardized questionnaire. The collected data were analyzed using SPSS Version 22 and the Excel program. Results: This study indicated that fewer than half (44%) of the participants fell within the 31- to 40-year-old age range. Over half (58%) had gastric ulcers, and a similar proportion (58%) expressed satisfaction with the definitions and risk factors. Half (50%) reported having satisfactory knowledge regarding the causes, while the majority (70%) demonstrated a satisfactory understanding of the complications of peptic ulcer disease. Almost all (92%) participants used medication for treatment, and over half (60%) reported the ineffectiveness of the medication in stabilizing ulcers as a personal barrier to treatment. Additionally, more than half (56%) cited low socioeconomic status as a socio-cultural barrier. Conclusion: The awareness of factors that aggravate peptic ulcers varied among individuals in Shendi City. Our study revealed that most people understood relevant food types, Helicobacter pylori, analgesic medications, coffee intake, smoking, and social stress. In contrast, weather changes, genetic predispositions, and body weight were associated with poor awareness. Ultimately, these findings should be validated by additional research involving a larger sample from the general population across various regions of Sudan.

Father of the subject or a field is a title given to an individual who is known to have given the first new important contribution to that discipline either through invention, discovery or laying down foundational principle that makes them distinct. However, in recent era, it is observed that there is breach in this system and individuals are being blindly or wrongly being labelled to be father’s without having any evidence of innovations/discoveries/foundational principles in that subject. Few individuals, especially in medical field have bizarre reasons and criteria’s attributed to them, for being called Father of the field. This has led to raise in Pseudo-fathers globally and has undermined the contribution of the original Fathers of the subject who have done discoveries or innovations. Disappointingly, many of them who are being called father of the subject, especially in medical field, don’t even have any contribution to the subject, yet they are being propagated as Father’s by their followers or students or association members. This article briefly highlights on criteria’s that makes one the Father of the field and also the disturbing trends.

Wastewater treatment plants (WWTPs) are recognized hotspots for the proliferation and dissemination of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs). As effluent discharge may introduce ARB into natural water ecosystems, assessing resistance patterns in these environments is critical to public and environmental health. This study aims to experimentally assess antibiotic resistance patterns in bacterial isolates from different stages of WWTP processes (influent, activated sludge, effluent), evaluating variations in resistance prevalence and identifying critical control points. Bacterial samples were collected across influent, biological treatment (activated sludge), and effluent from three municipal WWTPs. Standard microbiological culturing techniques were used to isolate representative bacteria (e.g., Escherichia coli, Pseudomonas spp., Enterococcus spp.). Isolates were subjected to antibiotic susceptibility testing against a panel of antibiotics (e.g., ampicillin, ciprofloxacin, tetracycline, vancomycin) using disk diffusion and minimal inhibitory concentration (MIC) assays, following CLSI guidelines. Resistance profiles were analyzed by stage and WWTP. Statistical analyses included chi-square tests and ANOVA to compare resistance rates across treatment stages. A total of 450 isolates were tested. Resistance prevalence significantly declined from influent to effluent for most antibiotics. For example, figure 1 shows a bar chart of percent resistance by sample stage: ampicillin resistance dropped from 75 % (influent) to 30 % (effluent); ciprofloxacin from 60 % to 25 %. figure 2 presents a line graph showing cumulative multi-drug resistance (MDR) rates decreasing across treatment stages. However, some isolates from effluent remained resistant to multiple antibiotics, including tetracycline and vancomycin. Findings highlight that conventional WWTP processes reduce—but do not eliminate—ARB. Results support the need for targeted disinfection or advanced tertiary treatments to minimize environmental release of resistance. Data provide a baseline for policymakers and engineers to strengthen wastewater treatment standards and safeguard public health.

Acute left-sided colonic diverticulitis can be categorized into complicated and uncomplicated. The surgical treatment for complicated diverticulitis can be divided into the sigmoid resection with stoma formation (Hartmann’s procedure) or sigmoid resection with anastomosis, accompanied by a protective ileostomy. In instances where patients with complicated left-sided diverticulitis are hemodynamically unstable, damage control surgery is indicated. Laparoscopic lavage serves as a bridging procedure for complicated diverticulitis with purulent discharge or classified as Hinchy 3, aiming to stabilize the patient for subsequent definitive surgery. This review will examine the surgical treatment of complicated left-sided diverticulitis, focusing on sigmoid resection with stoma (Hartmann’s procedure) and colonic resection with anastomosis. Additionally, the role of laparoscopic lavage in the treatment of complicated diverticulitis with purulent discharge will be explored.