One of the most important measures advocated for the prevention of transmission of the coronavirus disease 2019 (COVID‑19) infection is the use of a face mask.[1] However, this measure will not be useful if the compliance of the population is not good. The protection offered by the masks does not depend only on the type of mask but more importantly on how correctly the mask is used. The best and most efficient masks are the N95 and KF94 HEPA masks; however, they are uncomfortable to wear, need to be tightly fit to the face, and are costly. Comparatively, surgical masks are more comfortable and have long been proven to be effective; however, the loose‑fitting leads to possible leakage of aerosols. Cotton masks are much more comfortable but their efficacy is the least

Coronavirus disease 2019 (COVID‑19) is an ongoing pandemic that spreads mainly through close contact and tiny respiratory droplets. The ocular surface is a potential site for transmission, whereas the ophthalmologists are highly potential to acquire infection. Because of the presence of the angiotensin enzyme 2 in different ocular tissues and cytokine storm results in vasoconstriction, ischemia, hypercoagulopathy, and thromboembolic phenomenon, this virus easily binds and in different ocular manifestations such as conjunctivitis, retinal vascular occlusion, diabetes retinopathy, ocular nerve palsies, and orbital mucormycosis. Mucormycosis is a life‑threatening infection that often affects patients with diabetes mellitus and other immunocompromised patients. The diagnosis of mucormycosis is usually done by microbiological tests and radiological investigations. Proper ocular care and awareness among clinicians need the hour for prompt management of orbital mucormycosis. Here, we are presenting a case of COVID‑19‑associated mucormycosis with subconjunctival involvement of mucormycosis.

Objectives: This study aimed to assess the attitude and satisfaction of doctors toward clinical pharmacists’ role at Omdurman Military Hospital. Methods: A descriptive cross‑sectional study was conducted in Omdurman Military Hospital in Khartoum state, Sudan. A self‑administered questionnaire was delivered to 165 doctors who had previously worked with clinical pharmacists. Data were analyzed using Statistical Package for Social Sciences. The Chi-square test was used for the data analysis. Results: A total of 165 filled questionnaires were returned, 84 (50.9%) of them were males, and over 50% were aged under 31 years. Around 94.6% of them agreed that the clinical pharmacist is an important and integral part of the medical team, while 89.1% believed that clinical pharmacists could improve overall patient outcomes/quality of patient care. Collectively, 85.6% of the participants had a positive attitude toward the clinical pharmacist’s role. Moreover, the calculated overall satisfaction of doctors toward clinical pharmacy services showed that 83% had ahem with a high level of satisfaction. There was a significant relationship between doctors’ attitude and satisfaction with the area of practice, years of experience, and the duration of work in settings where clinical pharmacy service is provided. Conclusions: The study identified a positive attitude and high level of doctor satisfaction with clinical pharmacist role and confidence in the abilities of the clinical pharmacists, also found that doctors overwhelmingly favor the presence of clinical pharmacists, frequently seek their advice, and feel they improve the quality of patient care

Background: The quality of life (QoL) of pediatric oncology patients is multidimensional, including the social, physical, and emotional executive functions of the child and the family. The study aimed to assess QoL in pediatric patients with cancer on and off treatment and to determine the factors that affect the QoL. Methodology: This was a cross-sectional study that included 104 children aged between 7 and 17 years, who were recruited using a Non‑probability convenient sampling method. The Pediatric Quality of Life Inventory (PedsQL™ 4.0) generic core scale and the PedsQL™ 3.0 cancer module were used as data collection tools. The data were coded, entered, and analyzed by using Statistical Package for Social Sciences. T-test and ANOVA tests were used for the data analysis. Results: Out of 104 patients, males were 70 (67.3%). The QoL score mean was (71.68 ± 11), with the highest score was found in subscale procedural anxiety (86.54 ± 23.09), and the lowest score was found in subscales general health (44.47 ± 30.76). The older children showed the lowest QoL score (mean 68.38 ± 8.22) comparing to with younger age (70.5 ± 13.15). There were no significant differences between overall QoL scores and gender, type of cancer, and treatment status. Conclusion: Children reported an acceptable overall QoL score mean. There was no significant difference in QoL between males and females, treatment status, type of cancer. The total score of the PedsQL™ 4.0 scale was significantly correlated with pain, nausea, worry, cognitive problem, perceived physical appearance, and satisfaction subscales

Objective: The study objective was to explore the clinical observation of reducing the risk of gestational diabetes mellitus (GDM) in pregnant women with metabolic syndrome (MS) by dietary intervention during early pregnancy. Methods: Singleton pregnant women who set early pregnancy filings and had regular prenatal care and delivery at Zengcheng Hospital of Guangzhou Women and Children’s Medical Center of Guangdong Province from January 2020 to June 2021 were screened out according to the diagnostic criteria for MS promulgated by the International Diabetes Federation in 2005. Pregnant women meeting the diagnostic criteria for MS were randomly divided into the intervention group (n = 80) and the control group (n = 80). The changes in the indicators of MS (fasting plasma glucose [FPG], total cholesterol [TC], triglyceride [TG], high‑density lipoprotein [HDL], low‑density lipoprotein [LDL], systolic blood pressure [SBP], and diastolic blood pressure [DBP]) in early and late pregnancy were observed, and the incidence of GDM was analyzed. Results: There was no significant difference (P > 0.05) in TC, TG, FPG, LDL, HDL, SBP, or DBP of women in early pregnancy between the two groups. There was no significant difference (P > 0.05) in TC and TG of women in late pregnancy between the two groups. The FPG, LDL, SBP, and DBP of the intervention group were lower than those of the control group, and the HDL of the intervention group was higher than that of the control group, which showed a significant difference in the two groups (P < 0.05). The incidence of GDM in the intervention group was lower than those of the control group (P < 0.05). Conclusion: Pregnant women with MS before their pregnancy were at a high risk of GDM. Diet and exercise interventions in early pregnancy could improve the indicators of their blood metabolism and lipid metabolism, which could effectively reduce the incidence of GDM and thus improve the adverse pregnancy outcome and ensure the safety of the mothers and the infants.

Headache is a universal symptom in the course of everyone’s life. There are myriads of causes for headache ranging from simple migraine, tension headache, refractory errors in the eye, temporomandibular joint arthralgia, and myofascial spasm to severe form of headache by brain tumors. The anatomical variations in the nasal cavity result in mucosal contact between the opposing surface and cause rhinogenic contact point headache (RCPH). RCPH is a new type of headache in medical literature. The pathogenesis of the RCPH is still the subject of controversy. Nose has diverse anatomical variations. Deviated nasal septum or spur, middle turbinate concha bullosa, and enlarged bulla ethmoidalis are the common anatomical variation in the nasal cavity which can cause RCPH. Diagnostic nasal endoscopy and computed tomography scan are helpful to confirm the mucosal contact points inside the nasal cavity. The precise excision of the contact points with the help of endoscopic approach in patients of RCPH is very effective. Clinicians should not ignore the anatomical variation of the nasal cavity during management of the headache. There is not much literature for RCPH indicating that this clinical entity is neglected. This review article presents an overview of the current aspect of RCPH.

Background: Oral submucous fibrosis (OSMF) is a chronic premalignant condition seen in the oral cavity, but sometimes extends to the pharynx, esophagus, or even the larynx. OSMF causes stiffness in the oral cavity leads to trismus and affects speech and swallowing. Sometimes this lesion affects the Eustachian tube opening at the nasopharynx which results in Eustachian tube dysfunction followed by middle ear diseases. The purpose of the present work is to evaluate otological manifestations in OSMF patients. Materials and Methods: Patients with OSMF were evaluated for otological manifestations such as hearing impairment and fullness in the ear. All of them were evaluated with pure tone audiometry and tympanometry. Results: In this study group of 58 patients of OSMF comprising 116 ears, the hearing was within the normal limit in 60 ears (51.72%), a mild degree of conductive deafness in 52 ears(44.82%), a mild degree of sensorineural deafness in 2 ears(1.72%) and a moderate degree of sensorineural deafness were present in 2 ears(1.72%). There is a significant difference in mean quantitative hearing impairment was seen in OSMF groups C and group D with respect to the control group. Conclusion: Involvements of palatal muscles in OSMF patients reduce the patency of the Eustachian tube, resulting in a conductive type of deafness. OSMF patients should be assessed for hearing impairment and suggested for proper management.

Introduction: Catastrophic neurological decline, although exceedingly rare, takes a huge toll on pregnant population. In view of varied symptomatology and risks to the fetus, diagnosis and management of the neurological disorders in pregnancy is always a challenging task. The evaluation and management should be performed in a stepwise fashion and requires a multidisciplinary approach. Radiological imaging, especially magnetic resonance imaging (MRI), has revolutionized the diagnosis of these disorders, thereby exacerbating maternal and fetal outcome. Aim: The present study was conducted with the aim to characterize some of the significant neurological disorders complicating pregnancy and puerperium and to study the role of imaging, especially MRI, in differentiation and exclusion of various neurologic conditions, which helps an obstetrician to point to a specific diagnosis and management. Materials and Methods: Our study was an observational study conducted in the Department of Obstetrics and Gynecology in collaboration with the Department of Radiodiagnosis of GMC, Srinagar, from June 2018 to January 2020. The images were obtained with MRI and subjected for radiological interpretation. Results: A total of 750 patients were included in the study out of which 25 patients had neurological complications. Out of 25 patients, 13 were in the antenatal period and 12 were in the puerperium. There were 10 (40.0%) cases of posterior reversible encephalopathy syndrome (PRES), 6 (24%) cases of cerebral venous thrombosis (CVT), 3 (12.0%) cases of embolic infarcts, 2 (8.0%) cases of status epilepticus, 2 (8.0%) cases of pituitary apoplexy, 1 (4.0%) case of Wernicke encephalopathy, and 1 (4.0%) case of metastasis to brain (choriocarcinoma). Conclusion: Diagnosis of neurological complications of pregnancy and postpartum plays a crucial role in reducing fetomaternal morbidity and mortality. MRI stands above all imaging modalities in early diagnosis of these neurological complications, simultaneously taking care of fetal safety as well. The most common neurological complications that cause increased maternal mortality are PRES and CVT. Hence, early imaging can help in early and appropriate management of serious pregnancy-related neurological catastrophes.

Context: Ischemic stroke is an acute medical condition with life‑threatening complications; therefore, understanding its common risk factors, early management, prevention from recurrent attack, and in our population is necessary. Aim: The aim of this study is to assess common risk factors and management of ischemic stroke at Ibrahim Malik Teaching Hospital (Khartoum, Sudan). Methodology: A retrospective, hospital-based study was conducted at Ibrahim Malik Teaching Hospital Khartoum State. The study included all medical records of patients hospitalized with Ischemic stroke from January 2017 to January 2018. The data were collected using a well-designed data collection form and analyzed with SPSS. Results: Out of 116 participants, ischemic stroke was more frequent in males (59.5%), adults over 65 years (57.8%). Forty‑four percent of participants had a history of hypertension. Smoking and family history with ischemic stroke were observed only in 10.3% and 5.2% of participants, respectively. Aspirin (100–300) mg plus atorvastatin 40 mg were the most prescribed regimen of 44.8%. The highest type of drug-drug interaction reported was monitor closely (41.4%) and serious(33.6) type drug-drug interactions. While 74.1% of participants were discharged, the rate of death was significantly higher in females and participants over 65 years’ age. Conclusions: Past medical history of hypertension and elderly age were the major risk factors with ischemic stroke. Aspirin plus statin therapy is the most frequently used regimen with nonadherence to the guidelines regarding the use of thrombolytic therapy and anticoagulants. Serious type drug-drug interactions were detected among prescribed medications.

Background: The risk of lifestyle and environment will lead to an increase in cancer prevalence. Therefore, it needs managing support for palliative cancer patients. The purpose of the study was to obtain the correlation between social support characteristics and cancer patients’ quality of life. Method: This research using a cross-sectional approach was conducted in several palliative shelters. Samples were 93 respondents, obtained using a quota sampling technique. The variables used were social support (family, friends, and others) and the cancer patient’s quality of life. Result: The results showed that social support received at a high level was most obtained from the family as many as 65 respondents (69.9%). Furthermore, the social support factor of cancer patients related to the quality of life was friends’ support (p-value <0.05), while other factors were considered irrelevant. The collecting data technique was used due to the dynamics of patients seeking treatment at the West Java provincial referral hospital. Conclusion: the friend’s support is significant for improving the quality of life of cancer patients. Peer groups are an essential component in managing health care in the community.