Background: Hepatitis B is a serious chronic infection of the liver and caused by hepatitis B virus. It is an endemic disease in Sudan. Healthcare workers are occupationally[MS1]  more prone to acquire the disease. Evaluation of their knowledge, attitude and practice, and their vaccination status, are very important in the control of the disease. The aim of this study is to assess the knowledge, attitude, and practice of healthcare workers towards hepatitis B and their vaccination status.

BackgroundBreast cancer (BC) is the most common type of cancer in women. Among many risk factors of BC, mutations in BRCA2 gene were found to be the primary cause in 5–10% of cases. The majority of deleterious mutations are frameshift or nonsense mutations. Most of the reported BRCA2 mutations are protein truncating mutations.MethodsThe study aimed to describe the pattern of mutations including single nucleotide polymorphisms (SNPs) and variants of the BRCA2 (exon11) gene among Sudanese women patients diagnosed with BC. In this study a specific region of BRCA2 exon 11 was targeted using PCR and DNA sequencing.ResultsEarly onset cases 25/45 (55.6%) were premenopausal women with a mean age of 36.6 years. Multiparity was more frequent within the study amounting to 30 cases (66.6%), with a mean parity of 4.1. Ductal type tumor was the predominant type detected in 22 cases (48.8%) among the reported histotypes. A heterozygous monoallelic nonsense mutation at nucleotide 3385 was found in four patients out of 9, where TTA codon was converted into the stop codon TGA.ConclusionThis study detected a monoallelic nonsense mutation in four Sudanese female patients diagnosed with early onset BC from different families. Further work is needed to demonstrate its usefulness in screening of BC.

Introduction: Lymphedema is an abnormal accumulation of interstitial fluid, due to inefficient uptake and reduced flow, leading to swelling and disability, mostly in the extremities. Hereditary lymphedema usually occurs as an autosomal dominant trait with allelic heterogeneity. Methods: We identified single nucleotide polymorphisms (SNPs) in the FOXC2 gene using dbSNP, analyzed their effect on the resulting protein using VEP and Biomart, modelled the resulting protein using Project HOPE, identified gene – gene interactions using GeneMANIA and predicted miRNAs affected and the resulting effects of SNPs in the 5’ and 3’ regions using PolymiRTS. Results: We identified 473 SNPs - 429 were nsSNPs and 44 SNPs were in the 5’ and 3’ UTRs. In total, 2 SNPs - rs121909106 and rs121909107 - have deleterious effects on the resulting protein, and a 3D model confirmed those effects. The gene – gene interaction network showed the involvement of FOXC2 protein in the development of the lymphatic system. hsa-miR-6886-5p, hsa-miRS-6886-5p, hsa-miR-6720-3p, which were affected by the SNPs rs201118690, rs6413505, rs201914560, respectively, were the most important miRNAs affected, due to their high conservation score. Conclusions: rs121909106 and rs121909107 were predicted to have the most harmful effects, while hsa-miR-6886-5p, hsa-miR-6886-5p and hsa-miR-6720-3p were predicted to be the most important miRNAs affected. Computational biology tools have advantages and disadvantages, and the results they provide are predictions that require confirmation using methods such as functional studies.

Background: Epilepsy is a common disease with economic impact in form of frequent clinical visits, investigations and management. Objective: To estimate the direct and part of the indirect costs of epilepsy. Design and methods: The study was performed on a case series of medically treated Sudanese patients with epilepsy in a charity clinic. Data on clinical characteristics, utilization of medical services, and costs were collected from 38 patients using a standardized pre-tested format. The patients' approval was obtained as necessary. Results: Direct medical care costs was (2,395 Sudanese Pounds "SDG", 417 American Dollars "USD") per year per patient, of which antiepileptic drugs was the major component (1,587 SDG, 276 USD). Other costs are medical consultations and hospitalization charges (SDG 148, 26 USD), investigations cost (146 SDG, 25 USD), and cost of travel to clinics (514 SDG, 90 USD). Nonmedical direct cost -in form of traditional healers' visits were reported by 13.5% of the patients and estimated to be (1,422 SDG, 251 USD) per patient per year. The indirect cost was estimated for co-patients transportation, which is reported by patients who resides outside the state, making 7.9% of patients, and estimated to be (1,773 SDG, 308USD) per co-patient per year. The overall mean annual cost for epilepsy per patient in our clinic was approximately (2,724 SDG, 474 USD). Conclusion:The economic burden on epilepsy patients is heavy, and the contributors to the cost in Sudan have many similar features and some noteworthy differences with that of other countries.

Breaking bad news is a global challenge for all types of health providers. Our study assessed the attitude and practice from the doctors' perspective in a patriarchal society. A descriptive cross-sectional hospital-based study was conducted, involving doctors from both medical and surgical departments. Almost half of the respondents believed that Sudanese patients do not like to know their diagnosis, and a slightly higher proportion had no previous training on how to break bad news. Some 20% indicated that they would conceal the diagnosis from a patient if his or her relatives so requested. Less than one-quarter of respondents followed a standard protocol. Although most of the doctors subscribed to the notion that patients have the right to know everything about their illnesses, not all of them held this attitude towards their local patient population.