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Clinical Characteristics and Current Medical Practice in a Group of Sudanese Patients with Epilepsy: A Cross Sectional Hospital Based-Study

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Case Reports in Clinical Medicine 2021年第10期10卷 264-276页

作者： muaz elsayed Mohamed Issa Ibrahim Mahmoud Sarah Imam College of Medicine Omdurman Islamic University Omdurman Khartoum Sudan Omdurman Teaching Hospital Omdurman Khartoum Sudan College of Medicine University of Sharjah Sharjah UAE University Hospital of Sharjah Sharjah UAE

Introduction: The epilepsy classification in under developed countries faces many difficulties in reporting, work-up and management strategies. Exploring local practice in general hospitals will positively add to the welfare of patients with epilepsy. The objectives of this study were to assess the current medical practice in epilepsy work up and to study the selection of AEDs as per ILAE guidelines. Methods: This was a cross sectional-retrospective hospital based study, conducted between April and September 2016 in Omdurman Teaching Hospital, Khartoum, Sudan. Patients aged 18 years old and above were enrolled. Epilepsy was defined as having at least two non-provoked seizures in the least 6 months in a patient who was assessed by clinical review and electroencephalogram (EEG). Epilepsy was classified as generalized, focal or unclassified. Medications refer to all internationally licensed antiepileptic medications (AEDs) in 2016. Results: One hundred adult Sudanese patients were enrolled for this study. The most common event described during the ictal phase was tongue biting in 50% of participants followed by body stiffness in 46%. Epilepsy was classified as generalized in 84%, focal in 11% and unclassified in 5% patients. In generalized epilepsy, the MRI detected 23.3% abnormal findings higher than the CT which detected 14.8% (4/27), p value = 0.032. In focal epilepsy, the CT detected 75% abnormal findings higher than the MRI which detected 33.3%, p value = 0.02. The AEDs used were as follows: Carbamazepine (CBZ) 48%, Na valproate (VP) 33%, Lamotrigine (LMT) 2%, Levetricetan (LVT) 1%, CBZ + VP 14% and CBZ + Oxcarbazepine (OXC) 2%. Conclusion: The current medical practice in Omdurman teaching hospital should be modified to match the international league against epilepsy (ILAE) guidelines in workup, management, AEDs selection and classification of epilepsy.

关键词： Anti-Epileptic Drugs EEG Epilepsy Sudan

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Palinopsia as a Rare Presenting Symptom of Occipital Stroke “Case Report”

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Case Reports in Clinical Medicine 2021年第7期10卷 203-212页

作者： muaz Abdellatif elsayed Mohamed Atif Makdum Sheena Shirmilon Salim Nuzrath Salmin Abdul Razak University Hospital Sharjah Sharjah UAE

Palinopsia is the recurrence or persistence of visual images after cessation of the stimulus. Palinopsia has been associated with a wide variety of etiologies and mechanisms such as drug induced, seizures, migraine, psychiatric conditions, head trauma and structural lesions in the brain. We report a case of occipital stroke who presented with oscillating palinopsia. Sudden-onset palinopsia is a very rare symptom of stroke, but it must be recognized early as it is a highly time dependent, and potentially treatable condition. A 57-year-old woman with a history of poorly controlled type 2 diabetes, hyperlipidemia, and hypertension presented with sudden onset right sided palinopsia with images of her face and right forearm with hand, occurring several times in a day, lasting for a few minutes each time, and appearing in the same location each time. There are few case reports in literature secondary to stroke and what makes it interesting also is that she reported persistence of image even when her eyes are closed. Moreover, the sudden onset is not common in literature. The Magnetic Resonance Imaging (MRI) of the brain showed evidence of left Posterior Cerebral Artery (PCA) territorial (Fusiform gyrus) subacute ischemic infarction. Visual field assessment showed a right homonymous hemianopia. She was treated with aspirin and clopidogrel. The frequency and intensity of palinopsia reduced subsequently. The face image disappeared in the first week while the forearm image disintegrated gradually over the next few weeks. Palinopsia may be a rare presenting symptom of stroke. It is important for the clinician or emergency room doctors to be alert to the possibility of undiagnosed structural neurological lesions like occipital stroke and differentiate it from non-organic causes, as prompt management may reduce the risk of visual or motor disability.

关键词： Palinopsia Oscillating Occipital Stroke Hemianopia Case Report

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Florid Autonomic Features Associated with Medullary Lacunar Stroke

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International Journal of Clinical Medicine 2022年第12期13卷 679-690页

作者： muaz elsayed Akram Harazeen Asma Shams Pournamy Sarathchandran Feras Alrawi Tayseer Zain Samia Noor Department of Neurology Al Qassemi Hospital (EHS) Emirates Health Services Sharjah UAE Faculty of Medicine and Health Sciences Omdurman Islamic University Omdurman Sudan

Introduction: Autonomic nuclei affection results in variations in hemodynamics, temperature, sweating and ECG. Medullary strokes are challenging in their presentation, bizarre clinical signs, work and neurological outcome. The commonest cause is infarction of the posterior inferior cerebellar artery (PICA). Anatomical areas affected include the inferior cerebellar peduncle, dorsolateral medulla, nuclei of the Trigeminal, vestibular nuclei, Ninth and Vagus nerves. The descending sympathetic tracts and spin thalamic tracts. Serious cardiopulmonary events can complicate 11% of cases. Case Presentation: A middle-aged female developed sub-acute dizziness associated with vomiting and right head pains. She was unable to walk but remained cognitively clear. Her gastrointestinal symptoms were disabling and this was the main factor for presenting to the emergency room. The risk factors included hypertension and diabetes mellitus. Imaging studies were essential for posterior circulation stroke diagnosis and follow-up. She manifested remarkable autonomic features regarding the skin and hemodynamics. Nevertheless, the hospital course was controllable. Discussion: This case report was consistent with relevant literature in the contra lateral vaso motor changes and drop in body temperature during the acute phase. Moreover, our patient developed clinical and radiological extension through double antiplatelets. Superiority of the magnetic resonance imaging (MRI) scans in this patient enabled better diagnostic accuracy in a brainstem stroke. Conclusion: The autonomic features, in this case, represent major symptomatology and clinical signs. The variation in the hemodynamics and persistence of symptoms is thought provoking. This increases the awareness of emergency doctors for acute stroke presenting with autonomic features will enable early detection and helps outcome.

关键词： Autonomic Medullary Infarction Wallenberg’s Syndrome Brainstem Stroke

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The Pattern of Neurological Disorders;Revisited Prevalence Data of a Dedicated Neurology Clinic in Sudan

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Case Reports in Clinical Medicine 2021年第11期10卷 339-358页

作者： muaz elsayed Omer Aladil Abdalla Hamid Rayan Tonga Sara Misbah Elsadig Mohamed Hasan Ahmed Musaab Ahmed Mohamed Khalafallah Saeed Omdurman Islamic University Faculty of Medicine and Health Sciences Khartoum Sudan International University of Africa Faculty of Medicine and Health Sciences Khartoum Sudan MBBS Resident in Internal Medicine Sudan Medical Specialization Board SMSB Khartoum Sudan MRCP Senior Consultant Neurologist Soba University Hospital Department of Medicine Faculty of Medicine University of Khartoum Khartoum Sudan Department of Medicine and HIV Metabolic Clinic Milton Keynes University Hospital NHS Foundation Trust Eaglestone Milton Keynes Buckinghamshire UK College of Medicine Physiology Department Ajman University Ajman UAE The University of Science and Technology Faculty of Medicine Omdurman Teaching Hospital Khartoum Sudan

Background: The diverse modes in geographical locations, environmental factors, genetic and racial characteristics play a complex role in determining the pattern of neurological disorders worldwide. Determining the pattern of neurological disorders enables health policymakers to plan evidently for service, training, and research priorities. Few prevalence studies in neurology were conducted in Sudan. Methods: This is a retrospective hospital-based study that reviewed the medical records of patients who attended a Dedicated Neurology Clinic (DNC) in Omdurman, the national Capital of Sudan, for 24 months, from January 2016 to January 2018. This study aimed to determine the DNC pattern of neurological disorders as a representative subset prevalence in Sudan. Neurologists conducted the medical workup for diagnosis after at least two visits. All patients have ethically consented. Results: The total number of patients was 1050. Only 749 patients (71.3%) fulfilled the inclusion criteria. The mean age was 46.5 ± 1.9, and males were 45.3%. 72% were from the Capital. The presenting symptoms were headache (16.6%), seizures (11.5%), limbs weakness (11.2%), and lower percentages for other neurological symptoms. The commonest diagnoses were Stroke 12.4%, Epilepsy 9.3%, Primary Headache 8.8%, Movement Disorders 7.3%, Peripheral Neuropathy 6%, Dementia 4% Neuroinfections 1.4%, Demyelinating Disorders 2.6%, Spinal Spondylotic Radiculopathy 2.6% and 1.7% for Cerebral Venous Thrombosis. Conclusion: The data from Sudan-DNC showed that the most common neurological disorders descendingly were Stroke, Epilepsy, Headache, Movement Disorders, Peripheral Neuropathy, Dementia, Infections, Demyelinating Disorders, Spinal Spondylotic Radiculopathy, and Cerebral Venous Thrombosis. The demyelinating disorders and peripheral neuropathy showed a higher percentage than our previous preliminary prevalence study in 2012 compared to th

关键词： Sudan Prevalence Neurological Disorder Stroke Dedicated Clinic

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Florid Autonomic Features Associated with Medullary Lacunar Stroke

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International Journal of Clinical Medicine（临床医学国际期刊） 2022年第12期

作者： muaz elsayed Akram Harazeen Asma Shams Pournamy Sarathchandran Feras Alrawi Tayseer Zain Samia Noor

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The Pattern of Neurological Disorders; Revisited Prevalence Data of a Dedicated Neurology Clinic in Sudan

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Case Reports in Clinical Medicine（临床医学病理报告） 2021年第11期

作者： muaz elsayed Omer Aladil Abdalla Hamid Rayan Tonga Sara Misbah Elsadig Mohamed Hasan Ahmed Musaab Ahmed Mohamed Khalafallah Saeed

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Inhibition of retroviral Gag assembly by non-silencing miRNAs promotes autophagic viral degradation

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Protein & Cell 2018年第7期9卷 640-651页

作者： Na Qu Zhao Ma Mengrao Zhang muaz N. Rushdi Christopher J. Krueger Antony K. Chen Department of Biomedical Engineering College of Engineering Peking University Beijing 100871 China Wallace H Coulter Department of Biomedical-Engineering Georgia Institute of Technology Atlanta GA 30332 USA

We recently reported an unconventional mechanism by which miRNAs inhibit HIV-1 viral production. This occurs when miRNAs bind nonspecifically to the viral structural protein Gag, interfering with viral RNA-medi- ated Gag assembly at the plasma membrane. Conse- quently, misassembled viral complexes are redirected into the endocytic pathway where they are delivered to lysosomes for degradation. In this study, we demon- strate that autophagy is a critical mediator of the viral degradation pathway and that this pathway is not HIV-1 specific. Misassembled viral complexes were found to colocalize extensively with LC3 and p62 in late endo- somesllysosomes, demonstrating a convergence of autophagy with functional degradative compartments. Knocking down autophagosome formation machineries reduced this convergence, while treatment with autop- hagy-inducer rapamycin enhanced the convergence. Furthermore, similar autophagy-dependent nonspecific miRNA inhibition of murine leukemia virus （MLV） assembly was shown. Overall, these results reveal autophagy as a crucial regulator of the retroviral degradation pathway in host cells initiated by non- specific miRNA-Gag interactions. These findings could have significant implications for understanding how cells may regulate retroviral complex assembly by miRNA expression and autophagy, and raise the possi- bility that similar regulations can occur in other biolog- ical contexts.

关键词： microRNA Gag protein autophagy

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Analysis of TK and C18L Genes of Wild-type and Cell Culture Passaged Camelpox Virus

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Virologica Sinica 2013年第4期28卷 239-241页

作者： muaz M.Abdellatif Bashir Salim Awad A.Ibrahim Tigani Asil Abdelmalik I.Khalafalla Department of Microbiology Faculty of Veterinary Medicine University of Khartoum Department of Microbiology Faculty of Veterinary Science University of Nyala Southern Darfur P.O. Box 155 Nyala Sudan Department of Pathology Faculty of Veterinary Science University of Nyala Southern Darfur P.O. Box 155 Nyala Sudan

Dear Editor, Camelpox is an infectious skin disease of camels caused by camelpox virus (CMLV). It is confined to camel rearing belts of developing countries (Wernery U, et al., 2002). CMLV is classified in the Orthopo... 详细信息

关键词：痘病毒骆驼细胞培养野生型 L基因 C18 传染性皮肤病发展中国家

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A study of in vitro antibacterial activity of lanthanides complexes with a tetradentate Schiff base ligand

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Asian Pacific Journal of Tropical Biomedicine 2013年第5期3卷 367-370页

作者： Waleed Mahmoud Al Momani Ziyad Ahmed Taha Abdulaziz Mahmoud Ajlouni Qasem Mohammad Abu Shaqra muaz Al Zouby Department of Allied Medical Sciences Al Balqa' Applied University Department of Applied Chemical Sciences Jordan University of Science and Technology Medical Diagnostic Laboratories

Objective:To establish the antibacterial activity of lanthanides complexes with a tetradentate Schiff base ligand ***:(N,N'-bis(l-naphthaldimine)-o-phenylenediamine)was prepared from the condensation of 2—hydroxy-1-naphthaldehyde with o-phenylenediamine in a molar ratio of 2:*** antimicrobial activity of the resultant Ln(Ⅲ)complexes was investigated using agar well diffusion and micro-broth dilution techniques;the latter was used to establish the minimum inhibitory concentrations for each compound ***:Most of Ln(Ⅲ)complexes were found to exhibit antibacterial activities against a number of pathogenic bacteria with MICs ranging between 1.95-250.00μg/*** aureus was the most susceptible bacterial species to[LaL(NO_3)_2(H_2O)](NO_3)complex while Shigella dysenteriae and Escherichia coli required a relatively higher MIC(250μg/mL).Trie complexes La(Ⅲ)and Pr(Ⅲ)were effective inhibitors against Staphylococcus aureus,whereas Sm(Ⅲ)complex was effective against Serratia *** the other hand,Gd(Ⅲ),La(Ⅲ)and Nd(Ⅲ)were found to be more potent inhibitors against Pseudompnas aeruginosa than two of commonly used *** remaining Ln(Ⅲ)complexes showed no remarkable activity as compared to the two standard drugs ***:Tetradentate Schiff base ligand L and its complexes could be a potential antibacterial compounds after further investigation.

关键词： Antimicrobial Biomolecules Organics Synthetic ligands

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Migraine in physicians and final year medical students:A crosssectional insight into prevalence,self-awareness,and knowledge from Pakistan

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World Journal of Methodology 2022年第5期12卷 414-427页

作者： Hassan Choudry Fateen Ata Muhammad Naveed Naveed Alam Ruqaiya Ruqaiya Mahammed Khan Suheb Muhammad Qaiser Ikram Muhammad Muzammil Chouhdry muaz muaz Department of Respiratory Medicine University Hospital of LeicesterLeicester LE1United Kingdom Department of Internal Medicine Hamad Medical CorporationDoha 0000Qatar Department of Neurology Faisalabad Medical UniversityFaisalabad 38000PunjabPakistan Department of Neurocritical Care AdventhealthOrlandoFlorida 33662United States

BACKGROUND Despite its high prevalence,migraine remains underdiagnosed worldwide.A significant reason is the knowledge gap in physicians regarding diagnostic criteria,clinical features,and other clinical aspects of *** To measure the knowledge deficit in physicians and medical students and to assess the prevalence of migraine in the same *** An online questionnaire was developed and distributed among physicians and final year medical students on duty in various medical and surgical specialties of Allied and DHQ Hospitals,Faisalabad,between October 2018 and October *** criteria were public practicing physicians who experience headaches,while those who never experienced headaches were *** questions assessed respondents on their knowledge of triggers,diagnosis,management,and prophylaxis of the migraine *** were asked to diagnose themselves using embedded ICHD-3 diagnostic criteria for different types of ***,tables,and figures were made using Microsoft Office 2016 and Microsoft Visio,and data analysis was done in R Studio *** We had 213 respondents and 175 fulfilled inclusion criteria,with 99(52%),58(30%)and 12(6.3%)belonging to specialties of medicine,surgery,and others,*** genders were symmetrically represented(88 male and 87 female).Fifty-two(24.4%)of our 213 respondents were diagnosed with migraine,with 26(50%)being aware of *** had higher prevalence among study participants(n=28,32.2%)compared to males(n=20,22.7%,P=0.19).A majority(62%)of subjects never consulted any doctor for their ***,a majority(62%)either never heard or did not remember the diagnostic criteria of *** 38%falsely believed that having any type of aura is essential for diagnosing *** consultation rate was 37%(n=65),and migraineurs were significantly more likely to have consulted a doctor,and a neurologist in particular(P<0.001).Consulters and migraineurs fared bet

关键词： Migraine Headache disorders Knowledge study Prevalence Knowledge Epidemiology Public health

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