Articles

This study investigates the impact of socio-political disruptions on air quality in Khartoum, Sudan, focusing on key pollutants: Aerosol Optical Depth (AOD), Carbon Monoxide (CO), Nitrogen Dioxide (NO₂), and Sulfur Dioxide (SO₂). Using Sentinel-5P satellite data (2020–2024) processed in Google Earth Engine (GEE), spatial and temporal variations in pollutant levels were analyzed before and after a significant war event in April 2023. The methodology included data acquisition, preprocessing (e.g., cloud masking, spatial filtering), monthly averages computation, visualization, and statistical analysis using Google Earth Engine (GEE), ArcGIS Pro, and Microsoft Excel. Results showed a marked post-war increase in AOD levels, attributed to infrastructure destruction, fires, and diminished industrial oversight, alongside spatially consistent pollution patterns in some regions. CO concentrations exhibited an overall decline due to reduced industrial activities and transportation, though localized anomalies were linked to concentrated emissions. Similarly, NO₂ levels dropped significantly, reflecting reduced vehicular and industrial activities, while sporadic increases suggested localized emissions like generator use. SO₂ demonstrated mixed trends, with reduced mean levels but increased variability, indicating sporadic high-emission events linked to emergency fuel use or conflict-related disruptions. This study uniquely combines high-resolution satellite data with advanced spatial and temporal analysis techniques to reveal the nuanced and multi-pollutant impact of socio-political conflicts on air quality in Khartoum, providing novel insights into the environmental repercussions of armed conflicts. These findings highlight the profound impact of socio-political events on atmospheric pollution dynamics, underscoring the need for robust urban planning, targeted environmental monitoring, and policies to mitigate air quality deterioration and address public health concerns in conflict-prone regions. The study emphasizes the importance of satellite-based monitoring to provide critical insights into the environmental repercussions of socio-political upheavals.

This document has been translated from Spanish into English using ChatGPT. While efforts have been made to ensure accuracy and maintain the original meaning, some nuances or interpretations may differ from the source text. For any clarification, please refer to the original document or contact the author.This brief article addresses the concern arising from the accelerated whirlwind of changes of all kinds experienced by our social systems, some of which have a significant evolutionary impact, largely driven by advances in science and technology. Particular interest has emerged in connecting certain properties inherent to the behavior of complex systems far from equilibrium—such as social systems—under the framework of properties currently studied in Complexity Sciences. The article outlines this concern, which is, for now, merely the beginning of what could develop into a groundbreaking investigation. It references laboratory simulation work aimed at understanding the evolutionary horizons of Chile’s social system. The text includes an example of some graphs that illustrate a potential method for detecting and anticipating possible evolutionary horizons of the social system, based on the role played by certain “attractor variables” within the system. However, the research is still exploratory, and this article serves merely as a general description of the initial concern.

Dyspepsia refers to acute, chronic, or recurrent pain or discomfort centered in the upper abdomen. An international committee of clinical investigators (Rome III Committee) has defined Dyspepsia as Epigastric pain or Burning, early satiety, or postprandial fullness Dyspepsia occurs in 15 % of the Adult population and accounts for 3% of general medical office visits. The descriptive study was carried out in Eastern Afghanistan, Afghan Momand Medical Complex & Research Center, Department of Gastroenterology, during the years 2023-2024. To know the Clinico-Endoscopy of Dyspepsia, for patients who present with investigated Dyspepsia to Gastroenterological OPD & IPD. The study result showed, there were a total of patients 467, and of these patients 230 were Male and 237 were Female. According to the Age, 45 patients were under Age <20, 219 patients were between the ages 21-40 years, 130 patients were between ages 41-60 years and 73 patients were over 60 years of Age. However according to the presentation, 357 patients had Dyspepsia, 59 patients had Dysphagia, 13 patients had Chronic Liver Diseases & Screened for Varices, 3 patients presented after Acid ingestion, 2 patients had Anemia, 11 patients had persistent vomiting and 22 patients had suspected GI-Bleeding. Furthermore in Esophageal findings from a total of 467 patients 34 patients had Esophageal Candidacies, 6 patients had Esophageal Narrowing, 25 patients had Esophageal Growth, 71 patients had Hiatus Hernia, 180 patients had LA Grade A Esophagitis, 21 patients had LA Grade B Esophagitis, 6 patients had LA Grade C Esophagitis, 3 patient had LA Grade D Esophagitis. 16 patients had Lax Lower Esophageal Sphincter, 9 Patients had High-Risk Esophageal Varices, 3 patients had Small Esophageal Varices and 150 patients had Normal Esophagus and in Gastric findings from total all above patients, 4 patients had Antral Gastritis, 50 patients had Corpus Gastritis, 1 patient had Fundal Gastritis, 4 patients had Nodular Gastritis, 199 patients had Pan-Gastritis, 108 patients have Severe Pan Erosive Gastritis, 23 patient had Gastric Erosions, 6 patients had PHG (Portal Hypertensive Gastropathy), 3 Patients had Fundal Varices, 5 patients had Gastric Polyps, 5 patients had Gastric Growth, 2 patients had Pyloric Stenosis, 8 patients stomach not seen due to Esophageal Growth, 67 patients stomach were normal. In the present study there were Duodenal findings from a total of the above patients 48 had Duodenitis, 2 patients had Duodenal Polyps, 2 patients had duodenal ulcers, 1 patient had Duodenopathy, 2 patients had Duodenopathy, 2 patients Duodenum not seen due to Pyloric Stenosis and 413 patients Duodenum were normal. Regarding the habits in our study in which a total of 467 patients were examined 135 of the above patients had snuff habits, 103 patients had smoking habits, 2 patients were Heroin addicts and 227 of the total patients didn’t have any habits (the majority of them were using spicy food, overfeeding, drinking of nonalcoholic beverages, fatty foods, NSAIDs ...) and the higher incidence of Dyspepsia was in Female patients, Also with the age between 21-40 years (43%) patients, Also the higher incidence of Dysphagia 47% were in patients with Age >60 years, the Endoscopy showed that 83% patients had Gastritis also higher incidence regarding the habits 29% had snuff habit and 22% had a smoking habit.

Background: Sickle cell anaemia (SCA) in children demonstrates a broad range of clinical manifestations and serious complications. Assessment of disease severity in specific populations is necessary to plan services and optimise care. Aim: To describe the clinical severity of SCA and associated sociodemographic and clinical factors in children in Gambia.Methods: The presence of lifetime complications was confirmed by history and review of medical charts. We determined clinical severity using a validated scoring system and related the severity to sociodemographic and clinical factors.Results: In 130 study participants, ages ranged from 5 to 15 years with a mean (SD) age of 9.74 (2.81) years. Eleven (8.5%) children had had acute chest syndrome, 7 (5.4%) avascular necrosis of the femoral head, 6 (4.6%) gallstones, 5 (3.8%) stroke and 1 (0.8%) priapism over their lifetime. Disease severity was classified as mild in 108 (83.1%) children, moderate in 17 (13.1%) and severe in 5 (3.8%). Age, age at diagnosis, sex, ethnicity, social class, and treatment with hydroxyurea was not significantly correlated with SCA clinical severity (P values 0.10-0.84).Conclusion: The high proportion of children with mild disease may be due to the high prevalence of Senegalese β-haemoglobin haplotype in the Senegambia subregion. However, the presence of moderate or severe disease in almost 1 in 5 children calls for concerted efforts in SCD care in this region.

Stroke is a clinically defined syndrome of acute focal neurological deficit attributed to vascular injury (infarction, hemorrhage) of the central nervous system. Stroke is the second leading cause of death and disability worldwide. Stroke is not a single disease but can be caused by a wide range of risk factors, disease processes and mechanisms. Approximately 15% of strokes worldwide are the result of intracerebral hemorrhage, which can be deep (basal ganglia, brainstem), cerebellar or lobar. A minority (about 20%) of intracerebral hemorrhages are caused by macrovascular lesions (vascular malformations, aneurysms, cavernomas), venous sinus thrombosis or rarer causes.

Background: Outcomes of chemotherapy in adults with ALL in resource-poor countries are reportedly worse compared with outcomes in resource-rich countries. There are few comparative data on transplants in these settings.Methods: Retrospective analysis of 102 consecutive subjects > 18 years with ALL receiving an allotransplant from Jan 2007 to Sept 2022 in Jordan.Results: Median follow-up is 38 mo ([IQR] 16-80 mo). 81 subjects were men. The median age was 29 y(IQR 22-36 y). 63 were B-cell and 38, were T-cell lineage. 31 had the Ph-chromosome. 68 were in 1st and 34, ≥ 2nd histological complete remission. 97 received intensive conditioning. Donors were an HLA-identical sibling (N = 88) or an HLA-mis-matched relative (N = 14). Grafts were blood cells. Subjects received conventional GvHD prophylaxis, cyclophosphamide (N = 11) or ATG (N = 3). All subjects recovered bone marrow function with complete donor chimerism. 5-year leukemia-free survival (LFS), 58% (47, 69%) and survival, 45% (34, 56%). 45 subjects developed acute and 44, cGvHD. 3-year cumulative incidence of cGvHD was 28% (15, 42%). 5-year CIR was 32% (18, 45%) and 3-year NRM, 25% (15, 35%).Conclusion: Allotransplant outcomes in adults with ALL in Jordan, a resource-poor country, seem comparable to those reported in resource-rich countries.

Post-transplant malignancy is one of the contentious and feared consequences of Solid Organ Transplantation (SOT), which might detrimentally alter the outcome of transplantation. Risk factors are manifold, principally related to a suppressed immune system with intercurrent immunosuppressant medications commonly used in the context of SOT. Opportunistic viral infections encountered in SOT are crucial promoters of mitogenic proliferation in several common tumors. Lastly, immune suppressant therapy might trigger mitogenic changes directly.In this paper, we are discussing post-SOT malignancies, elaborating on the different phases of its pathogenesis, and elucidating on the different aspects that linger in its risk factors, preventive strategies, and management.

Bilateral trigeminal neuralgia refractory to medical therapy is a rare occurrence and it is mandatory to choose therapeutic procedures minimizing possible bilateral sensitive deficit due to the employment of bilateral mininvasive ablative techniques.  A patient affected by bilateral trigeminal neuralgia refractory to medical therapy secondary to multiple sclerosis is presented. Multiple therapeutic tools were employed in this challenging pathology. The second and third left trigeminal divisions were involved by the neuralgia, while the third division was involved in the right facial side. Controlled radiofrequency thermocoagulation was employed for the isolated right third division, then radiosurgery was conducted for the left hemifacial side.  After one month, because of the persistence of pain attacks of the left second trigeminal division, peripheral authorizations were performed. Control of pain, with the withdrawal of medical therapy (BNI scale class I), was achieved in this patient with a multi-therapeutic approach. Radiofrequency thermorizotomy was performed for the right third division because neuralgia was very acute, and immediate pain relief was achieved. Pain in the left third trigeminal division regressed after radiosurgery, while pain in the left second division continued after radiosurgery, then peripheral alcoholization was performed with pain control.Bilateral trigeminal neuralgia refractory to medical therapy should be treated by the dedicated neurosurgeon, avoiding bilateral ablative techniques for the same division and using neurosurgical techniques according to the trigeminal division interested by the neuralgia and according to the intensity of pain.

Direct myocardial transplant of HFDSCs (human fetal derived stem cells) by open chest surgical procedure was performed in 10 patients with Heart Failure (HF) due to no ischemic, no chagasic dilated cardiomyopathy. All 10 patients survived the operation. At 40 months, the mean (±SD) NYHA class decreased from 3.4 ± 0.5 to 1.33 ± 0.5 (p = .001); the mean EF increased 31%, from 26.6% ± F) 34.8% ± 7.2% (p = .005); and the mean ETT increased 291.3%, from 4.25 minutes to 16.63 minutes (128.9% increase in metabolic equivalents, from 2.46 to 5.63) (p < .0001); the mean LVEDD decreased 15%, from 6.85 ± 0.6 cm to 5.80 ± 0.58 cm (p < .001); mean performance in the 6-minute walk test increased by 43.2%, from 251 ± 113.1 seconds to 360  0 seconds (p = .01); the mean distance increased 64.4%, from 284.4  144.9 m to 468.2 ± 89.8 m (p = .004); and the mean result in the Minnesota test decreased from 71 ± 27.3 to 6 ± 5.9 (p < .001). Six patients survived after 40 months; 5 of them had complete reverse remodeling after 3 months after transplants. The average age at the moment of the transplants was 62 years (s/d 11.6). Results: The first patient died at 5,4 years for an infection; the second patient died at,7,4 years for heart failure; the third patient died at 8,4 years for heart failure; the fourth patient died at 10 years for heart failure and the fifth patient died at 14,4 years after transplant at the age of 83 for heart failure. The average age at the moment of death was 70 years (s/d12.9). The survival rate at 4 years was 100% (K/M) and at 14 years (25%K/M). Conclusion: These initial worldwide experiences with the surgical direct transplant of liver fetal stem cells in patients with end-stage HF shows clearly the positive effect in the reverse remodeling of the left ventricle of 50% of the cohort and excellent long-term results in these types of patients opening a new avenue for treating end-stage HF patients without any other option of treatment.

Intussusception is a leading cause of intestinal obstruction in young children, typically presenting with colicky abdominal pain and altered stool characteristics, before progressing to abdominal distension and bilious vomiting. This case report describes an 8-month-old male who presented with gastrointestinal symptoms, respiratory distress, and signs of intestinal obstruction. The patient was diagnosed with intussusception and found to be positive for Respiratory Syncytial Virus (RSV). After an attempted ultrasound-guided hydrostatic fluid enema, he underwent laparotomy to resolve the intussusception but developed post-operative complications, including delayed wound healing and wound dehiscence. The interplay of viral infections like RSV, and treatments such as steroids in pediatric surgical cases warrants further attention, especially concerning postoperative outcomes.