Introduction: Central nervous system involvement is one of the most devastating aspects of sickle cell disease. Objectives: The aim of this review is to document the range of neurological complications of sickle cell disease. Methods and materials: This is a descriptive cross-sectional Hospital based study. One hundred Sudanese patients with Sickle cell anemia were included in the study during the period from March to July 2018. Results: The most common age group affected was below 20 years, Male to female ratio was almost equal; irritability & headache were the most common symptoms 41%, 40% respectively. Numbness was observed in 25%, hemiplegia in 24%, seizure in 19%, recurrence of hemiplegia occurred in 8%, gait was found to be spastic in 14%, limping gait (due to non-neurological causes) in 7%, while inability to walk in 6% and cerebellar manifestation in 2%.Conclusion: The study revealed high incidence of irritability and headache followed by numbness then hemiplegia.Hemiplegia is usually ischemic in children and hemorrhagic in adults. Silent brain infarcts occur in 17% of patients. Convulsions occur as an isolated event but frequently associated with stroke.

COVID-19 is a multi-system disorder. Bell’s palsy is a lower motor neuron lesion that is uncommon after COVID-19 or related vaccinations. We documented two incidences of Bell’s palsy in this study, one after she was exposed to COVID-19 and the other after he was exposed to AstraZeneca Vaccine.

Background Epilepsy is a common disease, and its economic consequences are manifested in frequent hospital visits, examinations and treatments. Objective To estimate the direct costs of epilepsy among Sudanese epileptic patients. Design and methods The study was conducted on some clinical cases of epilepsy patients in Sudan. Data on clinical characteristics, utilization of medical services, and costs were collected from 380\ 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 overall mean annual cost for epilepsy per patient in our clinic was approximately (2,724 SDG, 474 USD). Conclusion The economic burden of epilepsy patients is relatively high, and payers in Sudan have many characteristics and significant differences from other countries.

Introduction: Diabetic neuropathies are thought to result from diabetic microvascular injury involving small blood vessels that supply nerves. Cardiac autonomic neuropathy (CAN) represents a serious complication associated with Diabetic neuropathies. Objectives: The aim of the study is to investigate the presence of cardiovascular diabetic autonomic neuropathy in a group of adult diabetic Sudanese patients with ischemic heart disease. Methodology: This is a descriptive prospective cross sectional hospital based study. The study population included type 1 and type 2 diabetic patients admitted to the cardiac care unit in ELshaab Teaching Hospital with acute coronary syndrome over a period of two years, from April 2017to April 2019. Results: A total of 49 males (65.33%) and 26 females (34.67%) were included in the study. CAN was detected in 94.67% of the studied group Conclusion: An incidence of 94.67% cardiovascular autonomic neuropathy in our sample indicates a high occurrence of this syndrome among our diabetic patients. Poor glycemic control is a common feature among our studied group. Sub-clinical autonomic neuropathy can be detected early using autonomic function tests.

Background and aims:Adverse effects are leading causes of treatment failure with antiepileptic drugs(AEDs).We studied the cosmetic effects of AEDs and their association with medications adherence and quality of life .MethodsThe study was performed on Sudanese epilepsy patients attending Daoud charity (June-September2014). Five main variables were used(1)Cosmetic effects profile;(2) Morisky Medication Adherence Scale (MMAS-8);(3)WHO Quality of Life Brief-26;(4)Socio-demographic data ,and (5)Epilepsy related data. A senior neurologist assessed the cosmetic effects through clinical examination of the patients. Consents have been obtained from all patients.ResultOut of 420 patients male were (54.15%) and female were (45.85%),mean age 34.1+-10.4 years. Hair loss was the most commonly reported cosmetic effect by female patients (75%) who were taking sodium valproate.(26.2%)of patients had weight gain and none of them thought weight gain is an adverse effect. Neither of life score, nor adherence score were correlated with any of the cosmetic effects of AEDs (P > 0.05).A significant positive correlations was found between the duration from the last attack and the quality of life score (P = 0.03). The Gum overgrowth was correlated with hirsutism and Acne(P > 0.05).Conclusion: We concluded that our patients prioritize medications intake in spite of the presence of cosmetic effects, and this-together with absence of association between quality of life and the cosmetic effect-may be attributed to different Sudanese patients perception to these cosmetic effects from other populations in addition to the unique Sudanese culture.