Background: Upper respiratory tract infections (URTIs) are mainly viral in their etiologies but sometimes are complicated by secondary bacterial infections detected by the persistence of symptoms. This study aimed to evaluate community pharmacist’s knowledge and practice regarding URTIs. Methods: A descriptive cross-sectional study was performed using self-administered questionnaire. The study targeted 338 community pharmacists selected randomly from community pharmacies in Khartoum state. The overall knowledge and practice scores were calculated, then the associations between these scores and demographic characteristics were evaluated using Chi-square test and analyzed by statistical package for social sciences. Results: Out of 327 pharmacists, 65.4% of them were females. Whereas pharmacists with B. Pharm. represented 79.1%. Regarding the knowledge, it was found that 59.7% of community pharmacists have sufficient knowledge toward URTIs, while 40.3% of them have insufficient knowledge. Community pharmacists exhibited varying degrees of practice, but most of them have a good practice. Furthermore, 52.6% of them reported patient’s interest as barrier to counseling, while 38.9% reported pharmacy crowdedness as a barrier. Statistically, higher knowledge scores are associated mainly with female gender and educational levels. On the another hand, 64.4% of the participants relied on medical websites as a source of information. Conclusion: Community pharmacists have good knowledge about URTIs. The practice is diverse, but good practice is mainly linked to those with sufficient knowledge. Most of the community pharmacists relied on medical websites as a source of information.

The vascular anatomy of the anterior inferior cerebellar artery (AICA) is highly variable. In respect to the neurovascular relationship in the internal auditory canal (IAC), the AICA is intimately related with vestibulocochlear and facial nerve. Vascular loop of AICA, especially located in the IAC, is rare. This vascular loop of the IAC may result in the compression over the vestibulocochlear nerve. Microvascular compression of the eighth cranial nerve is an important cause for disabling tinnitus, vertigo, and hearing loss. Disabling tinnitus and vertigo due to intrameatal vascular loop of AICA compression, the vestibulocochlear nerve can be treated with help of drilling the internal acoustic meatus and separate the vascular loop from the vestibulocochlear nerve. The intrameatal AICA and vestibulocochlear nerve conflict produce specific pathological features and their surgical treatment is also invariably challenging. Decompression of the vestibulocochlear nerve by the opening of the IAC and transposition of the AICA is thought to be an effective treatment modality for radiologically confirmed cases with clinical presentations of unilateral sensorineural hearing loss and pulsatile tinnitus. The aim of this review article is to describe the details of vascular anatomy, etiopathology, clinical presentations, diagnosis, neurophysiology, and current treatment of the vascular loop of AICA in IAC which often pose challenge to the clinicians.

Dysuria refers to pain, discomfort, or burning sensation when urinating. It is most commonly caused by bacterial infections of the urinary tract. Some of the common causes of painful urination include lower urinary tract infection such as cystitis or bladder infection, upper urinary tract infection such as pyelonephritis or kidney infection, urethritis, and vaginitis. Dysuria is a known symptom of a bladder infection (cystitis). Cystitis is very common among women aged 20–50 years. An infection often starts when bacteria get into the urinary tract through the urethra. Once bacteria enter a woman’s urethra, it only has to travel a short distance to the bladder. In men over 50 years of age, a bladder infection usually is associated with prostate infection or an enlarged prostate. Pyelonephritis is more common in women than in men. Factors that can increase your chance of kidney infections include abnormal bladder function, advanced age, diabetes, enlarged prostate, infants and young children with an abnormal backflow of urine from the bladder to the kidneys (called vesicoureteral reflux) or an obstruction related to abnormal development of the urinary tract, persistent kidney stones, pregnancy, and urinary catheter in place.

Background: Prostate cancer is the most common visceral cancer in males, ranking as the second most common cause of cancer-related deaths in men older than 50 years of age, after carcinoma of the lung. It is predominantly a disease of older males, with a peak incidence between the ages of 65 and 75 years. This study aimed to estimate the plasma zinc level and plasma prostate‑specific antigen (PSA) level in patients suffer from prostate cancer. Materials and Methods: A case–control study was conducted in Khartoum on 100 males aged more than 50 years old which were divided into 50 apparently healthy as control and 50 with prostate cancer as case. A 5 ml of blood specimens was collected in lithium heparin anticoagulants for the estimation of plasma zinc level using Buck model 210 VGP Atomic Absorption Spectrophotometer (East Norwalk, CT 06855) made in the USA and the plasma total PSA that was measured by immunoassay Sandwich principle HITACHI ROCHE COBAS E 411 (serial number 04641655190 V 13.0). Results: The mean level of plasma zinc was 0.35 mg/L ± standard deviation [SD] 0.14 in case and in control was 0.68mg/L ± SD 0.13, so the P value was 0.002 and PSA was 43.08 ng/ml ± SD 20.08 in case and 3.53 ng/ml ± SD 3.90 in control, so the P value was 0.000, the correlation between the level of plasma PSA with plasma zinc in patients with prostate cancer give R was 0.01 and R2 was 0.001. Conclusion: This study concluded that PSA is significantly increased in patients with prostate cancer and plasma zinc level is significantly decreased in patients with prostate cancer. However, it is statistically significant.

Background: Deep neck abscess is a life‑threatening clinical entity. It can result in significant morbidity for the patients. Deep neck abscess continues to be commonly found in developing countries like India. Methods: A retrospective study was conducted at tertiary care teaching hospital in eastern India from September 2016 to October 2021. The medical records of patients diagnosed with deep neck abscesses with an
age range between 18 years and 65 years were reviewed. This study analyzes the etiology, clinical manifestations, diagnosis, and treatment of the deep neck abscess. Results: There was a predominance of male patients with deep neck abscesses (62.12%) and a mean age of 32.4 years. The most common clinical manifestation was fever (26.51%), followed by odynophagia (23.48%), neck swelling (20.45%), restricted neck movement (13.63%), otalgia (12.12%), trismus (11.36%), neck pain (10.60%), and stridor (2.27%). The peritonsillar abscess (28.78%) was the most commonly affected space of the deep neck abscess of this study. The important life-threatening complication in this study was stridor (2.27%). Conclusion: Early diagnosis, aggressive surgical intervention, and proper airway management are important factors for reducing the morbidity and mortality associated with deep neck abscesses.

Introduction: Stapedius muscle is the smallest bone in the human body and it has an important role for preventing loud noise exposing to the inner ear. This stapedius muscle has also a very significant role during stapes surgery for otosclerosis. Materials and Methods: We studied the microscopic anatomy of the 36‑stapedius muscle at our temporal bone dissection laboratory during the period of March 2019 to April 2021. All the 36 fresh temporal bones were dissected with the help of the microdrill, burr, and Zeiss microscope. Details of the stapedius muscle anatomy such as origin, extension, and attachment were studied. Results: The length of the stapedius muscle was ranging from 8 to 11 mm. The tendon of the stapedius muscle was ranging from 1.5 to 2.5 mm. The classical shape of the stapedius muscle was sickle shape. The bulky bell of the stapedius muscle was from 1.5 to 3.5 mm. Discussion and Conclusion: Clear anatomical knowledge of the stapedius muscle is needed for the postgraduates and during learning period of the otologist. If anatomical knowledge is not clear, it may lead to confusion between the stapedius muscle and facial nerve. Awareness regarding microscopic anatomic is required for avoiding the confusion between the facial nerve and stapedius muscle or during the facial nerve grafting.

Introduction: Coronavirus disease 2019 (COVID‑19) is defined as an illness caused by a novel coronavirus which is an emerging respiratory infection that was first discovered in December 2019, in Wuhan city, Hubei Province, China, finally named severe acute respiratory syndrome coronavirus 2. This study aimed to evaluate the current level of knowledge regarding transmission, symptoms, and preventive measures of COVID‑19 among the general population in Sudan. Objective: The objective of the study was to assess knowledge, attitude, and practice toward COVID‑19 among Sudanese resident. Methodology: This was a cross sectional, descriptive, community-based study for 1000 respondents selected by convenience sampling technique in seven localities of Khartoum state, Sudan between the periods April 9 and June 9, 2020. Data were collected using a pre designed pretested questionnaire and analyzed using the Statistical Package for the Social Sciences software, version 23.0 (IBM SPSS Inc., Chicago, IL, USA). Results: Sixty‑four percent of the population had good knowledge regarding COVID‑19 clinical presentations transmission routes, prevention method, and self‑isolation. Forty‑four percent of the population had poor attitude regarding COVID‑19 situation. Forty‑two percent of the population had poor practice regarding COVID‑19 preventive measures. There is a positive association between knowledge and attitude (P = 0.000001), positive association between knowledge and practice (P = 0.000001), and an insignificant negative association between attitude and practice (P = 0.453). Conclusions: Sudanese had a good level of knowledge and good practices compared to other nearby countries despite their economic state and lack of possibilities. The stressor experienced by the Sudanese citizens had huge effect on their negative attitude. Recommendations: Because good practices depend on good knowledge, it recommends to increase the level of knowledge about the disease, ways of transmission and prevention especially for women, elderly retired, unemployed, and those with low education level, rural resident using all the means of communication available (television and radio, awareness seminars, posters for guidance and alert in mosques, and the houses of worship) by clear, easy, simple language suitable for the elderly and uneducated.

Actinomycosis is an uncommon chronic disease caused by filamentous Actinomyces, a Gram-positive anaerobic bacterium that usually colonizes in the human oral cavity, digestive tract, and genital area. Actinomycosis is rarely seen chronic infectious disease in the head-and-neck region. The clinical presentations are often nonspecific and mimic several diseases of the head‑and‑neck area such as malignancy and tuberculosis. Moreover, investigations such as imaging, fine‑needle aspiration, and biopsy are often nonspecific. The diagnosis of actinomycosis is still difficult for the diagnosis at present time. Bacterial culture and histopathological study are the cornerstones of the diagnosis but a particular situation is needed to get the exact diagnosis. The prolonged bacterial cultures in anaerobic conditions are required to confirm the bacterium and classical microscopic findings like necrosis with yellowish sulfur granules and filamentous Gram‑positive fungal‑like pathogens. The surgical excision of the lesion/mass along with appropriate antibiotic therapy is important treatment options. Clinicians must be aware of the typical clinical presentations of actinomycosis in the head-and-neck region as it may mimic the malignant process in the head-and-neck area. Actinomycosis patients need prolonged high doses of penicillin G or amoxicillin and the period of antimicrobial treatment can be shortened to a minimum of 3 months in patients in whom optimum surgical resection of the infected tissues has been useful.

Incidental radiological findings have been often noted in routinepractice in all specialties. Many of them relate to specific specialty, but in rare instances, unusual radiological signs may also be seen in different specialty clinics which then follow appropriate referral of the case. It is not unlikely to witness incidental radiology findings in orthopedics, the discipline that heavily prescribes and depends on radiological investigations. A 43‑year‑old male patient presented to us with left side shoulder region injury 3 weeks ago which was painful despite no appreciable functional limitation. There were history of dyspnea on exertion and history of old untreated goiter. The lower border of goiter was not palpable even on deglutition, thus suggesting retrosternal extension. The radiograph of the shoulder and chest region was done which revealed a uniting middle third clavicle fracture. There was a radiopaque mass lesion noted in the neck region which on careful observation was pushing the trachea to the right side. The tracheal narrowing was evident and the mass had intrathoracic extension. On a clinicoradiological basis, a provisional diagnosis of retrosternal goiter with scabbard trachea was made, and the case was referred to the respiratory medicine department for further evaluation.

The Ndjavera conducted a randomized controlled trial in which 24 patients who were recently diagnosed with prostate cancer (PCa) and were commencing androgen deprivation therapy (ADT) completed 60 min of supervised aerobic and resistance training twice per week for 3 months, followed by 3 months of unsupervised training, and according to the results of the trial, there were improvements in health-related quality of life among PCa patients after participating in the training, and exercise was found to mitigate ADT-induced cardiovascular toxicity. Based on the outcome of a recent review study conducted by Cormie and Zopf, a supervised integrated moderate-to-vigorous intensity aerobic, resistance, and impact exercise was effective in improving neuromuscular performance, bone health, cognitive performance, physical health, mental health, and cardiopulmonary fitness among PCa patients undergoing ADT. They also found that supervised exercise training overseen by an expert led to weight loss, decrease in cancer-related fatigue, improvements in sexual function, and health-related quality of life among PCa patients undergoing ADT.