COVID-19 surveillance report for Sudan, 2020 to 2021.

Background: Following the World Health Organization declaration, COVID-19 was first appearance in Sudan was in March 2020. Cases were reported to the Sudan Federal Ministry of Heath through the surveillance system from different sources. This study used surveillance data from 2020 to 2021 to describe the epidemiologic patterns of COVID-19 occurrence in Sudan and provide insight for better preparedness and response. Methods: Through a retrospective descriptive study, COVID19 cases records obtained from the national surveillance line-list in Surveillance and Information Directorate in Federal Ministry of Health. The analysis of data was done with SPSS version 21. Descriptive analysis done by frequencies and percentages, and further analysis through performing multivariate logistic regression. Results: Out of 48,545 suspected cases tested for COVID-19 using RT-PCR, 27,453 (56.5%) tested positive with case fatality ratio of 6.5%. Higher death rate among elderly (78% > 60-year-old) and males (70.1%). From the reported cases, 53.8% showed no symptoms, while the common symptoms among symptomatic patients were; fever (26.4%), cough (19.1%), shortness of breath (16.8%) with small proportion (4.5%) reported loss of smell and taste. Specific states, Khartoum, Gezira and Red Sea showed highest prevalence. The disease peaked four times during 2020-2021, with a proposed alert threshold of 200-250 cases per week acting as an explosion point nationwide. Conclusions: The high case fatality rate in the country requires further analysis, as well as the high proportion of asymptomatic infection. This will be ensured by improving the quality and completeness of surveillance data. A proposed threshold of 200-250 cases per week should be an alert to augment the measures of controlling the pandemic over the country, including providing enough supplies to decrease mortality.

Asymmetric dual-core liquid crystal channel-based tunable mode converter.

In this work, a higher order-to-fundamental mode converter is reported and analyzed based on an asymmetric dual channel waveguide (ADC-WG) on silicon. In the reported structure, one of the two waveguides is infiltrated with nematic liquid crystal (NLC) material to add temperature tunability while the other one is a solid BK7 waveguide. The modal characteristics are obtained using the full vectorial finite difference method (FVFDM). In addition, the structural parameters and optical characteristics of the employed materials are investigated to achieve good wavelength selectivity with a short device length (LD). Thus, a compact mode converter that can work at different wavelengths including the telecommunication wavelength i.e., 1.55 µm with LD ~ 482.31 µm and a low crosstalk of - 19.86 dB is presented. To prove the thermal tunability of the suggested mode converter, its operation is tested through a temperature range between 20 and 35 °C and the results show that the mode conversion process is achieved at each temperature with different phase matching wavelengths (λPMW) but with quite similar coupling length (LC). The proposed device can therefore be effectively utilized in integrated photonic circuits.

Association of IL-17A rs2275913, IL-23R rs11209026 polymorphisms and serum level of IL-17A with rheumatoid arthritis in Egyptian patients.

Several studies have reported genetic polymorphisms at the IL-23/IL-17 axis linked to rheumatoid arthritis (RA) in many populations. We aimed to investigate the association of IL-17A rs2275913 and IL-23R rs11209026 polymorphisms with susceptibility to RA and, disease clinical features and the serum level of IL-17A in Egyptian patients. This case-control study included 94 RA cases and 74 controls. TaqMan genotyping assays were used for detection of gene polymorphism and the enzyme-linked immunosorbent assay was used to quantify IL-17A serum level. There was significant difference between RA patients and controls in genotypic distribution and allelic frequency of IL-17A rs 2275913 (p < 0.0001). The GG genotype had 7 times higher risk for RA development (OR=7.04: 95% CI 2.11:23.46, p value= 0.001). Also, GG genotype was associated with higher level of serum IL-17 A compared to GA and AA genotypes (p < 0.0001). Moreover, patients carrying the GG genotype had higher disease activity score 28 (DAS28) score (4.99±0.84) compared to patients with GA (2.73±0.52, p < 0.0001) and patients with AA genotypes (2.67±0.41, p < 0.0001). Genotypic distribution of IL-23R rs11209026 was significantly different between RA patients and controls (p < 0.0001), but there was no difference between the allelic frequency in both groups (p=0.08). IL-23R rs11209026 SNP was not a risk for RA development. However, DAS28 was lower in AA genotype than AG and GG genotypes (p=0.002, p=0.009 respectively). The mean serum IL-17A level was higher among the RA patients (39.07±10.47 pg./ mL) compared to controls (15.23±1.88 pg/ mL; p < 0.0001). Also, there was a positive correlation between IL-17A serum level and DAS28 score (Spearman r = 0.42; p value < 0.0001). We concluded that the variant IL-17A (rs2275913) genotype could be a risk factor for RA in our population and IL-17A may play a crucial role in the development and pathogenesis of RA.

Cerebrovascular changes in neuro-Behcet's disease and neuropsychiatric lupus by transcranial Doppler ultrasonography and magnetic resonance imaging

ABSTRACT Introduction: Transcranial Doppler ultrasonography (TCD) is a technique that allows measurement of blood flow from the basal intracerebral vessels. It is relatively inexpensive, non-invasive, can be performed at the bedside, and allows monitoring in acute emergency settings and for prolonged periods with a high temporal resolution, making it ideal for studying the haemodynamics within the intracranial arteries in neuro-Behcet's disease (NBD) and neuro-psychiatric lupus (NPSLE). Our aim was to assess the cerebral haemodynamic patterns in patients with NBD and NPSLE using TCD, while brain lesions were examined using magnetic resonance imaging (MRI). Material and methods: Case-control prospective study of 30 neuro-Behcet's disease patients, 25 neuro-psychiatric lupus patients and 26 healthy age-matched volunteers. All patients and healthy controls were examined by TCD. Only the groups of patients underwent cranial magnetic resonance imaging (MRI). Results: Transcranial Doppler (TCD) values for middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), vertebral artery (VA) and basilar artery (BA) in NBD, NPSLE and control groups were measured. The results showed that there was a significant decrease in mean blood flow velocities in all the arteries examined in NBD and NPSLE patients. There was also a significant increase in the pulsatile index of PCA, VA and BA between NBD and NPSLE patients. The same results were obtained when comparing NBD versus controls. However, there was no significant difference between the NPSLE patients and the control group. The MRI lesions described were parenchymal lesions in 14 patients (46.7%), and vascular lesions in 4 patients (13.3%). Vascular lesions co-existed with parenchymal lesions (mixed lesion). Parenchymal lesions were in white matter (40%), thalamus (26.7%), brain stem (26.7%) and cerebellum (20%). While, in NPSLE, 23 patients were normal (92%) and only two patients had a vascular lesion (8%). Conclusion: There was a significant decrease in mean blood flow and a significant increase in the pulsatile index among both NBD and NPSLE patients, according to the TCD values.

One-Dimensional Topological Photonic Crystal Mirror Heterostructure for Sensing.

A paradigm for high-quality factor (Q) with a substantial fulfillment for appraising sensing ability and performance has been investigated. Through constructing a 1D (one-dimensional) topological photonic crystal (PhC) mirror heterostructure, which is formed by the image view of 1D topological PhC stacking with its original one. In the 1D topological PhC-mirror heterostructure, there is an interesting mode that appeared with the symmetric, typical Lorentzian-line shape with 100% transmittance in the topological mirror edge-state mode (hybrid resonance mode) at the heterostructure interface. Physically, such a mode is a defect mode, but the defect is introduced through topological operations. The high Q-factor of 5.08 × 104 is obtained due to the strong optical localization of the defect mode at the topological edge area. Consequently, this device acts as a narrow passband filter. Moreover, due to the narrow bandpass property, it may be an advantageous reference for many applications in filtering, switching, and sensing. Thus, introducing an electro-optical (EO) polymer layer at the interface to modify the edge defect can tune the defect mode both in frequency and Q-factor for higher spatial pulse compression and higher EO sensitivity. Accordingly, the Q-factor of 105, the sensitivity of 616 nm/RIU, and the figure of merit of 49,677.42 RIU-1 are obtained. The sensing ability and performance are attributable to the strong optical localization in the interface region and enhanced light-matter interaction. We predict that the 1D topological PhC mirror heterostructure will be an outstanding point in the field of optical sensing, filters, and optical switching in different fields.

Resorbable polylactic acid polymer plates in repair of blow-out orbital floor fractures.

PURPOSE: To evaluate the use of the resorbable polylactic acid polymer implants (Resorb X) in the management of orbital floor blow-out fractures as regards safety, cosmetic, and functional results. METHODS: In a prospective, interventional case series, 22 patients with traumatic blow-out floor fractures underwent lower fornix transconjunctival repair using polylactic acid implant insertion over the defect without fixation. Orbital imaging was done preoperatively, at 1 month and 1 year postoperatively with orbital computed tomography with 2 mm cuts of axial, sagittal, and coronal scans. Outcome measures included the maximum vertical height of the orbit at the fracture plane and its changes over time. RESULTS: At the final follow-up, both limitation of elevation and diplopia improved in 82% of cases, while 63.6% of cases showed improvement of enophthalmos. Radiological restoration of the orbital vertical height was recorded in 100% of cases without implant displacement at 1 month. However, after 1 year, a significant floor bowing was found in 45.5% of cases, which showed a strong positive correlation with preoperative defect size (r = 0.820). CONCLUSIONS: Resorb X mesh plates can be a good option for the safe reconstruction of orbital floor blow-out fractures. Good anatomical and functional results were obtained in small orbital floor defects. Late bowing under pressure may limit their use in medium-sized floor defects.

Diagnostic and prognostic value of anti-CarP antibodies in a sample of Egyptian rheumatoid arthritis patients.

INTRODUCTION: Detection of autoantibodies in sera of rheumatoid arthritis (RA) patients has an important role in diagnosis and management strategies. Recently, another type of autoantibodies has been detected with activity against carbamylated proteins (anti-CarP) which may play an important role in the diagnosis of RA. The aim of this study was to raise knowledge about the diagnostic and prognostic value of anti-CarP antibodies in RA. MATERIALS AND METHODS: Seventy RA patients and thirty-four controls were included in this study. DAS28 was used to evaluate disease activity. Joint erosions were assessed by Larsen score using plain X-ray of involved joints of hands and feet. Serum samples were analyzed for anti-CarP antibody titer using the ELISA technique. RESULTS: Out of 70 patients, 35.7% were positive for anti-CarP and only 5.88% of controls had high titer above the cut-off value. A total of 24.29% of the patients were RF-negative and 30% were ACPA-negative. Five patients (29.41%) of the negative RF group were positive for anti-CarP. Four patients (19%) of the ACPA-negative group were positive for anti-CarP, and three patients (4.28%) of the total number of patients were triple negative and seventeen (24.28%) were triple positive. There was a significant correlation between anti-CarP titer and both DAS28 and Larsen scores only in the positive anti-CarP group. In addition, there was a strong association between anti-CarP antibody titer and joint erosions at both baseline and after 1-year follow-up. CONCLUSION: Presence of the anti-CarP antibodies in sera of RA patients may have a prognostic value as it correlates with the disease activity and joint erosions; moreover, it may have a diagnostic value in rheumatoid arthritis especially in RF- and ACPA-negative patients. Key Points • This study was carried out to raise our knowledge about the importance of anti-CarP antibodies in predicting the prognosis of RA. • This study was carried out to assess the correlation between anti-CarP antibodies, disease activity, and joint erosions. • This study was carried out to state the extent to which we can rely on the anti-CarP antibodies as a biomarker for prediction of RA.

Docosahexaenoic acid-enriched egg consumption induces accretion of arachidonic acid in erythrocytes of elderly patients.

Many studies in humans volunteers have shown that dietary docosahexaenoic acid (DHA) supplied as triacylglycerol can increase DHA levels in blood lipids but often strongly decreases those of arachidonic acid (AA). The aim of the present study was to determine the effect of dietary supplementation with egg-yolk powder enriched in DHA, corresponding to the French recommended dietary allowance for DHA, on the blood lipid status of an elderly population. Institutionalised elderly individuals aged between 63 and 93 years consumed an egg product enriched in DHA (150 mg/d) once daily for 9 months. Plasma lipids and the fatty acid composition of erythrocyte membranes were determined every 3 months. The supplementation induced an increase in the PUFA content of plasma and erythrocyte membranes which was +14.5 and +25.3 %, respectively, at 9 months. This effect was mainly due to the level of DHA and, unexpectedly, to that of AA which continuously increased. This increase in AA was the result of an increased dietary intake (+50 mg/d) and very probably of an increased biosynthesis as demonstrated by the behaviour of di-homo-gamma-linolenic acid. The supplementation resulted in a blood PUFA status comparable with that of young healthy controls. The data are consistent with a strong regulatory action of the dietary treatment on the subjects' lipid metabolism.