The pharyngeal pouch (Zenker's diverticulum) is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle (i.e. above the upper sphincter of the oesophagus). It occurs commonly in elderly patients (over 70 year) and the typical symptoms include dysphagia, regurgitation, chronic cough, aspiration and weight loss. We are reporting a case of an oropharyngeal dysphagia due to a Zenker's diverticulum in 75 years old Sudanese man with a chronic history of dysphagia for solids. The pathophysiology of Zenker's diverticulum, clinical presentation, and management are reviewed.

Background: Esophageal cancer (EC) is among the most common malignancies in Eastern Africa, but the occurrence of EC in Sudan has rarely been described in the scientific literature. This paper reports the results of a consecutive case series of all EC patients who visited one of the two public cancer treatment centers in the country in 1999-2012, providing a first description of this disease in a treatment center located in central Sudan. Materials and Methods: Clinical and demographic data for all EC patients who visited the Department of Oncology of the National Cancer Institute at the University of Gezira (NCI-UG) from 1999 to the end of 2012 were abstracted and tabulated by sex, tumor type and other characteristics. Results: A total of 448 EC patients visited NCI-UG in 1999-2012, and the annual number of EC cases increased steadily from 1999. Squamous cell carcinoma (SCC) was the predominant EC tumor type (90%), and adenocarcinoma (ADC) was reported in 9.4% of the EC cases. The overall male-to-female ratio for EC was 1:1.8, but the ratio was tumor type-dependent, being 1:2 for SCC and 2:1 for ADC. Only 20% of EC patients reported having ever used tobacco and/or alcohol, and the vast majority of these patients were male. At the time of EC diagnosis, 47.3% of the patients resided in Gezira State. Some EC patients from Gezira State seek out-of-state treatment in the national capital of Khartoum instead of visiting NCI-UG. Conclusions: The annual number of EC patients visiting NCI-UG has increased in recent years, approximately half of these patients being from Gezira State. Although this consecutive series of EC patients who visited NCI-UG was complete, it did not capture all EC patients from the state. A populationbased cancer registry would provide more complete data required to better understand EC patterns and risk factors.

Background and Aims Corona virus disease‐19 (COVID‐19) is a recently discovered infection that transmitted briskly worldwide. In this disease (COVID‐19), it was discovered that several disorders, such diabetes, increased the severity and fatality rate. Until now, studies investigating the correlation between diabetes and COVID‐19 in Sudan have not yet been conducted. Thus we aimed to evaluated the characteristics and outcomes of COVID‐19 among diabetic patients Methods A prospective study included 70 diabetic patients with COVID‐19 in Wad‐Medani Isolation Center from September to December 2020. Data concerning demographics and clinical characteristics, as well as outcomes were collected. Results Out of 70 patients, 46 (66%) were men and 24 (34%) were women; the average age was 63 ± 12 years. In diabetes mellitus (DM) types, 69 (98.6%) patient were T2DM. The average of DM duration was 10 ± 6.2 years. Insulin was the major DM medication used by more one‐half of study patients ( n = 37; 52.9%). Newly discovered DM after COVD‐19 infection was encountered in 5 (7.1%) patients. Most of the study subjects ( n = 44; 63%) had moderately severe form of disease. Hypertension was the commonest comorbid in 29 (41.4%) patients. The intensive care unit admission rate among our study group was 10% ( n = 7). The mortality rate among our study patients was found to be 11.4% ( n = 8). Dead patients were significantly had high HbA1c levels (11.6 ± 7% vs. 8.8 ± 5%; p = 0.001). Additionally, all individuals with a severe COVID‐19 illness ( n = 6; 100%) were dead comparing to no patient died with mild covid illness and 4.5% patients with moderately severe infection ( p < 0.001). Conclusion The majority of COVID‐19 diabetic patients were males and older in age. Most of the patients presented with moderate severity and moderately uncontrolled DM. Hypertension was the major comorbidity. The mortality rate was as high as 11.4% and associated with high HbA1c levels and severe form of COVID‐19 as well.

Background: Nonspecific colitis is an inflammatory Bowel Disease (IBD) that runs a clinically benign course. Histopathologically it is characterized by superficial mucosal erosions with lymphocytic infiltration in the lamina propria with no granuloma. Aim of this study: is to describe the clinical presentation of Non-Specific Colitis (NSC), and to evaluate its response to 5-aminosalicylic acid (5-ASA) in Sudanese patients. Setting and Design:This study is a prospective cohort. A total of 26 patients presenting with bloody, mucoid diarrhoea, lower abdominal pain or colonic mass were included in the study. Methods and Materials: A total of 26 patients presenting with bloody mucoid diarrhoea, lower abdominal pain with or without colonic mass were included in the study. All patients underwent colonoscopy. Statistical analysis: A descriptive statistical analysis was done using SPSS. Results: 19 (%) of patients were males and 7 were females with male to female ratio of 3:1. The majority of patients 16 (61.6%) had bloody diarrhea while 18 (69.2%) opened their bowel 4-6 times a day. The majority 10 (38.8%) had rectum and sigmoid involvement. All patients showed a good response to 5-ASA. Conclusions: This study showed that NSC has clinical features that are very much similar to mild UC with a rather good clinical response to oral 5-ASA.

Background: The novel coronavirus (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in December of 2019 in the city of Wuhan, China. In addition to respiratory symptoms, reports are emerging of neurological manifestations of SARS‐CoV‐2 Objective: To assess the neurological manifestations in COVID-19 positive patients. Methods: A cross sectional, prospective, descriptive, hospital based study included 106 COVID-19 patients in Gezira COVID-19 Centre during the period from June to September 2020. Data regarding demographics, clinical history, presentations, laboratory investigations, neuroimaging and outcomes were collected. Results: 106 COVID-19 patients were included in this study, 67(63.2%) were males and 39(36.8%) were females, their mean age was 68±4.3 years and most of them 58(54.7%) aged above 60 years. The main respiratory symptoms of COVID 19 were dyspnea in 66(62.3%), fever in 59(55.7%), cough in 50(47.2%) patients. The non specific neurological symptoms of COVID-19 were headache in 29(27.4%), dizziness in 9(8.5%) and syncope in one (0.9%) patient. Symptoms of COVID-19 related to cranial nerves such as change in smell (n= 87; 82.1%) and dyskinesia (n=80; 75.4%) were the most common neurological manifestations encountered. Focal neurological deficits were TIA in 2(1.9%), intracranial hemorrhage in one (0.9%) and transverse myelitis in one (0.9%) patient. Conclusion: The study showed that neurological manifestations of COVID-19 were common and mostly olfactory and gustatory dysfunctions among Sudanese subjects. Also, COVID-19 could be a risk factor for stroke and transverse myelitis. The study suggest that objective olfactory and gustatory may be needed to determine their clinical significance.