Objective : 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 . Methods : The 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. Results: Out 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). Significance : 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.

Tuberculosis(TB) is a common disease in Sudan .Neurological consequences of TB are frequently encountered in our practice of neurology particularly tuberculosis of the spine(Pott,s disease).There are few case reports of tuberculous myelitis in literature.

Background Migraine — an episodic headache —is one of the most common types of primary Headache. Migraine is considered a serious health problem that affects the quality of life. During university life, students often report increased levels of stress, depression, anxiety, and irregular sleep, all of which are associated with migraines.Our aim was to determine the prevalence of migraine headaches among medical campus students at university of Khartoum, Sudan. Based on available data, migraine is on the rise in both general populations as well as university students. Methods In this cross-sectional and descriptive study, study population was composed of students registered to faculty of medicine, Dentistry and pharmacy at Khartoum University in the academic years of 2020-2021. Out of these 318 of them accepted to participate. Participants who had two or more headaches in the last 3 months formed the headache group. Afterwards, two preliminary questions were applied to the headache group and participants with at least one affirmative response were asked to perform the validated ID-Migraine™ test. Results The mean age of 318 students participated in the study was 19.23 ± 1.84 (17-39 years), with adolescents: adult ratio being 2.5:1. 1613 students (43.7%) did have at least two headaches in the last three months. Migraine-type headache was detected in 266 subjects (7.2%) based on the ID-Migraine™ test. Of the migraine group, 72 were male (27.1%) and 194 were female (72.9%). There was no significant difference in migraine prevalence between adolescent and adult age groups. Conclusions With prevalence similar to adults, primary care physicians should be aware of the probability of migraine headaches in university students in order to maintain a successful school performance.

Background: Many studies done during this pandemic revealed several neurological manifestations related to coronavirus disease 2019 or COVID 19 infection. The aim of this narrative review is to discuss the neurological manifestations and complications of COVID-19 disease. Methods: Data were retrieved from: PubMed, Scopus, Science direct in addition to manual search using Google scholar from December 2019–May 2020.Keywords were used in the search such as COVID-19; Neurological manifestations; Cranial nerves; Motor system. Results: Neurological manifestations and complications are common and increase with the severity of the respiratory involvement . It ranges from 34% to reach 80% in some studies. It involves the central and peripheral nervous system leading to cranial nerves palsies and limbs paralysis. Conclusion: Neurological complications of COVID-19 is an important determinant for the severity and mortality of patients .The virus can lead to Headache, Convulsion, Mental and Psychic changes , Delirium and Insomnia (the most affected cranial nerve is the olfactory nerve leading to anosmia), Stroke (mainly infarction), Encephalitis, Meningitis , Guillain-Barre Syndrome ,Relapse of Multiple Sclerosis and Transverse Myelitis.

Cryptogenic Stroke in an Adult Sudanese Female with Interatrial Septal Aneurysm: A Case ReportMahmoud Hussien Salih Daoud1, Ejlal Ahmed.E. Abushama2, Abdallah H. Mahmmoud3, Mohammed Mahmmoud Fadelallah Eljack4, Khabab Abbasher Hussien Mohamed Ahmed5, Mazin S. Hassan Haroun6, Elfatih A. Hasabo7, Duaa Baderaldeen Ibraheem Elsheikh8, Sulieman Abdelkareim G. Mohammed9, Ahmed Eltayeb O. Eltayeb10, Yusif Abduelmagid M. Naimallah11, Alameen Ahmed Alameen Ahmed12, Mohamed Yusif Mohamed Yusif13, Asmaa Esam Abbas Mokhtar14, Sara Nasreldeen Ibrahim Awadalbari15, Rowida Babikir Osman Eltayeb16

IgG4 related Inflammatory Pancreatic Head Pseudotumor Mirror Pancreatic Carcinoma: A Novel Case Series with a Review of the LiteratureFaheemullah Khan, MBBS, MD1, Jehanzeb Shahid, MBBS, FCPS2, Amna Saleem, MBBS3, Uzzam Ahmed Khawaja, MBBS4, Wasim Ahmed Memon, MBBS, FCPS5, Uffan Zafar, MBBS6, Tariq Abdul Hameed, MD, DABR7, Khabab Abbasher Hussien Mohamed Ahmed, MBBS8* 1,2,5,6Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan.3,4Jinnah Medical and Dental College, Karachi, Pakistan.7Department of Radiology, Indiana University School of Medicine, Indiana, US.8Faculty of Medicine, University of Khartoum, Khartoum, SudanFaheemullah Khan : Email: islamianfellow@hotmail.com, ORCID:https://orcid.org/0000-0001-6369-743XJehanzeb Shahid: Email:jehanzeb.shahid@aku.eduAmna Saleem: Email: amna.saleem41@hotmail.comUzzam Ahmed Khawaja: Email: uzzamahmedkhawaja@gmail.comWasim Ahmed Memon:Email:wasim.memon@aku.eduTariq Abdul Hameed: Email: thameed@iupui.eduKhabab Abbasher Hussien Mohamed Ahmed: Email: khabab9722@gmaail.com, ORCID:https://orcid.org/0000-0003-4608-5321Article type : Case SeriesAbstract: 105Main text : 1907 (Main document)Tables : 0Figures : 5References : 27Pages : 10

Cerebrovascular accident (CVA) is one of the commonest neurological deficits. There is a well-known association between COVID-19 and stroke. We present a case series of Sudanese patients who developed CVA after receiving the AstraZeneca COVID-19 vaccine suggesting a relationship between the vaccine and CVA.

Yellow nail syndrome is a rare lymphatic abnormality without a clear pathogenesis. Hereby, we report A 70-year Sudanese female who presented with recurrent cough, recurrent lower limb swelling and yellowish nail discoloration diagnosed as yellow nail syndrome but unfortunately passed away due to acute respiratory distress syndrome (ARDS).

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.

HIV can be associated with cardiovascular complications. We highlight unusual presentation of HIV patient with MI and stroke. 30 year old HIV male presented with MI complicated by stroke. Recovered within 5 days with anti-ischemic and diuretics. Screening tests for unusual presentations prevent fatal complications of common diseases.

Acute pericarditis is uncommon presentation of COVID-19. Here we described a case of 50-year-old male who presented with chest pain without fever nor cough and diagnosed with acute pericarditis complicated by pericardial effusion due to COVID-19 after exclusion of other cause and receive supportive treatment and improve over two weeks.

HIV can be associated with cardiovascular complications. We highlight unusual presentation of HIV patient with MI and stroke. 30 year old HIV male presented with MI complicated by stroke. Recovered within 5 days with anti-ischemic and diuretics. Screening tests for unusual presentations prevent fatal complications of common diseases.