Objective: The objective of this study was to assess the accuracy of radiographic Singh index (SI) with respect to dual-energy X-ray absorptiometry (DEXA) scan in diagnosing osteoporosis. Materials and Methods: We conducted a cross-sectional study on 100 postmenopausal women in the Department of Radiodiagnosis, SKIMS, Soura, Srinagar, from June 2019 to December 2019. We obtained right or left standard anteroposterior hip radiograph in each patient and compared its SI grade to the densitometry results obtained from the DEXA study of the corresponding hip. Results: Out of the selected patients, 7% had DEXA bone mineral density (BMD) values in normal range (T‑score ≤1), 81% in osteopenic range (T‑score >1.00–<2.5), and 12% in osteoporotic range (T‑score ≥2.5). There was no statistically significant correlation (r = −0.108, P = 0.286) between SI grade and WHO BMD category (normal, osteopenia, or osteoporosis). There was no statistically significant correlation (r = 0.191, P = 0.057) between the SI grade and the mean absolute DEXA BMD value. There was also no statistically significant correlation (r = −0.195, P = 0.052) between SI grade and mean DEXA T‑score. Conclusion: Our study found a poor correlation between radiographic SI and DEXA densitometry results. We concluded that the SI cannot be used as a substitute for DEXA study in diagnosing osteoporosis.

Background: Fibroid is the most frequently recorded benign, monoclonal smooth muscle tumor of the uterus, affecting 20%–60% women of reproductive age. Being remarkably common, fibroids are an important health concern. Fibroids are the most frequent indication for the performance of hysterectomy. The health-care consequences of these tumors are substantial both for the mother as well as the fetus. Objective: The objective is to study the obstetric outcome in pregnancies complicated with uterine fibroids. Materials and Methods: This is an observational study conducted in the Department of Obstetrics and Gynaecology, SKIMS, Soura, Srinagar, from May 2019 to February 2020. A prospective evaluation of a series of 28 antenatal patients presenting with fibroids (>1 cm), who delivered in our hospital was done. Maternal age, parity, size of fibroid, type of fibroid, complications during pregnancy, and mode of delivery were noted. Ultrasonogram was done at booking visit and during subsequent visits to assess the size of the fibroid and degeneration. Obstetric outcome was assessed in terms of abortion, premature delivery, malpresentation, abruption, postpartum hemorrhage (PPH), subinvolution, and puerperal pyrexia. Fetal outcome was assessed in terms of intrauterine growth retardation (IUGR), low-birth weight, and neonatal intensive care unit (NICU) admissions. Results: Majority of the patients belonged to the age group of 25–29 years (35.7%), majority 19 (67.9%) were multigravida, most 17 (60.7%) of the fibroids were >3 cm in size. There were 2 (7.1%) cases of miscarriage, 6 (21.4%) cases of malpresentation, abruption in 2 (7.1%) cases, 3 (10.7%) had PPH and only 1 (3.6%) needed blood transfusion. A total of 18 (69.2%) patients delivered by lower segment caesarean section and 8 (30.7%) had vaginal delivery. Of 26 babies, 6 (23.1%) had low‑birthweight, 2 (7.7%) were IUGR and there were 2 (7.7%) NICU admissions. Conclusion: Even though most of the fibroids in pregnancy are asymptomatic but such pregnancies should be considered as high risk pregnancies. Hence, pregnancy has to be cautiously screened in the antenatal period, through regular follow-up, to detect any adverse obstetric complications thereby improving fetomaternal outcome. Our study also suggests that reduction in fibroid size pre‑pregnancy may play a vital role in preventing maternal and fetal complications which became inevitable once pregnancy reaches advanced gestation.

Background: Deep venous thrombosis(DVT) considered a common emergent condition with life-threatening complications that require rapid intervention with an effective antithrombotic drug regimen; for that, this study was conducted. The current study aimed to evaluate the use and outcomes of heparins in treating acute DVT at selected hospitals in Khartoum state. Methods: A descriptive retrospective, hospital-based study was conducted in different hospitals at Khartoum state from July 2016 to July 2017. The sample size was 147 participants. Data were collected using a well-designed data collection form and analyzed with the Statistical Package for the Social Sciences. Results: A total of 147 DVT patients were included, most of them (77.6%) were females, and 49.8% of them were old and aged more than 60 years. The patients with a past medical history of major surgery were represented 27.9%. Low‑molecular‑weight heparins (LMWHs) were the most prescribed drugs (74.1%), of which enoxaparin at a dose of 6000 IU twice per day is the most frequently prescribed in 32% of the patients. LMWHs were shown to achieve their therapeutic goal of activated partial thromboplastin time earlier compared with unfractionated heparin (UFH). Enoxaparin 6000 IU twice daily was the most suitable regimen, since it achieved its therapeutic goal within 3 days and maintained it for up to 5 days. 86.1% of the patients were discharged to their homes, whereas 12.9% were dead, and the percentage of death increased with advanced age. Conclusions: Past medical history of major surgery and advanced age were the major risk factors of DVT. LMWHs are the most frequently used drugs and were more effective than UFH, and enoxaparin 6000 IU twice per day was the most suitable regimen as a fixed dose for adults.

The current novel coronavirus disease 2019 (COVID‑19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). COVID‑19 is presenting a significant challenges to the surgical specialties specifically otolaryngologists and head and neck specialties those are dealing with upper airway such as larynx, trachea, and bronchus. The traditional airway procedure like microlaryngeal surgery, tracheostomy, and bronchoscopy are highly aerosol generating surgery often managed by otolaryngologists. The laryngotracheobronchial airway has a high viral density and so it is expected to expel more transmission of the infections in COVID‑19 pandemic. This is why the otolaryngologists or laryngologists are more vulnerable medical professional in this dreaded pandemic. Surgeons have high risk for getting the infections during examinations or surgical procedure on the laryngotracheobronchial airway. The surgical interventions should adopt adequate precautions to limit the viral dissemination. Effective management of the suspicious or positive cases of COVID‑19 required careful consideration for the safety of the surgeons and associated team members for ensuring the best possible care of the patients. This review article will provide an overview of common methods to limit the viral transmission to the otolaryngologists/surgeons and assisting health care staffs from COVID‑19 infections during management of the laryngotracheobronchial airway.

The Corona Virus Disease-2019 (COVID-19) outbreak has overwhelmed the public health authorities and the health care delivery system of multiple nations. The ongoing pandemic is caused by one of the viruses – SARS-CoV-2, belonging to the coronaviruses family. The genetic sequence of the isolated virus was similar among all the initial patients from Wuhan, which clearly indicate that the outbreak began from a single point introduction among the humans. At present, it is critical to understand about the origin of the virus, as it is a novel viral infection. These findings will aid us in getting significant insights about the start of the outbreak or the origin of the virus and thus we will be able to mount a better public health emergency response. In conclusion, in order to contain the COVID-19 pandemic, it is vital to identify the source of the virus and then take appropriate prevention and control measures, otherwise there is always a potential risk of reintroduction of the virus in the future once again and then once again we might be facing the challenge of containing the outbreak.

The Corona Virus Disease-2019 (COVID-19) infection has been reported among all, regardless of their region, nation, ethnicity, religion, age-group, gender, socioeconomic class and work profile. Against this novel viral infection, the health care workers are the only group of professionals who are working right from the day one, when the first case was reported and nothing was known about the infection. It is extremely important to protect health care professionals from infection both in the hospital and community settings. A wide range of factors has been attributed to the acquisition of infection among health workers in hospital settings. In conclusion, the role of health care professionals in the containment of the COVID-19 pandemic is of utmost importance and thus it is crucial to get more epidemiological insights about the infection and thus ensure their safety and well-being in the workplace.

Myomectomy is the most common surgery with cesarean section. There is a controversy between obstetricians about doing myomectomy with cesarean section. A 29‑year‑old primigravida patient presented with a massive lower segment myoma, who underwent myomectomy during cesarean section at term pregnancy. She did not have intraoperative hemorrhage or any postpartum complications. There seems to be no absolute contraindication for myomectomy during cesarean section especially if the surgeon has enough experience even if the myoma is large, located at the lower segment

Coronavirus disease 2019 (COVID‑19) has struck fear into populaces all through the world and shocked the worldwide restorative community, with the World Health Organization pronouncing it a widespread as it were approximately 3 months after the flare‑up of the infection. A new different virus(primarily called “novel coronavirus 2019 [nCoV]”) causing severe acute respiratory syndrome (COVID‑19) emerged in Wuhan, Hubei Province, China, in December 2019 and rapidly spread to other parts of China and other countries around the world. The outbreak of the nCoV disease (COVID‑19) has caused more than 850,000 people infected and approx. 40,000 of deaths in more than 190 countries up to March 2020, extremely affecting economic and social development. Presently, the number of infections and deaths is still increasing rapidly. COVID‑19 seriously threatens human health, production, life, social functioning, and international relations. In the fight against COVID‑19, geographic information systems(GIS) and big data technologies have played an important role in many aspects. This article describes the usage of practical GIS and mapping dashboards and applications for monitoring the coronavirus epidemic and related activities as they spread around the world. At the fact level, in the generation of massive data, information no longer come on the whole from the authorities but are gathered from greater diverse enterprises. As of now and for a long time in future, the improvement of GIS should be fortified to create a data‑driven framework for fast information securing, which implies that GIS ought to be utilized to fortify the social operation parameterization of models and methods, particularly when giving back for social administration.

Introduction: Hypertension has the highest prevalence among the major non‑communicable diseases in Sudan (prevalence 27.6%) due to high amount of salt intake in foods, lack of exercise, obesity, stress, smoking, and increase in age. Different guidelines have been proposed from time to time to increase the number of patients with controlled blood pressure. It is a well-established fact that poor disease control i largely related to the poor patient compliance to medical advice and medications. However, the other important aspect of the same problem is the physician’s adherence to evidence-based management of hypertension, but, unfortunately, this has not been studied adequately. Objective: The objective is to investigate adherence practices of health care providers to the use of clinical practice guidelines in Khartoum, Sudan. Materials and Methods: An observational cross‑sectional study was carried out from February to April 2020 among health‑care providers which include prescribing doctors and community pharmacists in Khartoum locality. Data were collected using electronic delivery validated questionnaire. Results: A total of 200 health‑care professionals (HCPs) voluntary participated, 51% were pharmacists, while 49% were prescribing doctors. As overall 86.125% of participated health‑care provider aware about hypertension as a health problem as a mean of their correct responses. In the area of measurement and management of a new case of hypertension, the mean of the responses (mean of correct answers) which follow guidelines was 55.75%. In the area of selection of anti-hypertensive treatment in comorbid conditions the mean responses of correct responses was 58.88%. Conclusions: Our study observed that the majority of HCP adhere to guidelines for hypertension in Khartoum locality. The study showed a lack of knowledge among HCPs in managing hypertension in patients with the comorbid condition.

Background: Beclomethasone dipropionate inhaler is a corticosteroid medication used as the controller of persistent asthma. Montelukast is a leukotriene receptor antagonist used as the second-line in controlling the symptoms of the asthmatic child. Objective: The objective of this study is to determine the comparison between the effects of beclomethasone dipropionate inhaler and montelukast on the total serum level of immunoglobulin E (IgE) and childhood asthma control test (C-ACT) in asthmatic children. Patients and Methods: A randomized clinical trial was done in Kerbala Teaching Hospital of pediatric from August 2014 to the end of October 2015, 97 patients were collected from asthma outpatient clinic aged 4 to 11 years with mild persistent asthma and randomly divided into beclomethasone group (51 patients) and montelukast group (46 patients), the total serum IgE was done before the initiation of treatment, and another reading was done after 3 months. The score of symptoms control was evaluated by C-ACT after 1 month of treatment, and another evaluation was done 2 months later. Results: There was a significant reduction in total serum IgE level (21% for montelukast group and 27% for beclomethasone group) after 3 months of treatment compared to baseline IgE, and there was significant improvement in childhood C‑ACT scores (16% for montelukast group and 24% for beclomethasone group) after 3 months of treatment compared to the 1st month of treatment. There was a significant improvement in the beclomethasone group compared to the montelukast group after 3 months of treatment. Conclusions: Both beclomethasone and montelukast are effective controllers for asthma symptoms and reducing the total serum IgE level. Beclomethasone is better than montelukast in improving C-ACT scores.