The Pattern of Neurological Disorders;Revisited Prevalence Data of a Dedicated Neurology Clinic in Sudan

Background: The diverse modes in geographical locations, environmental factors, genetic and racial characteristics play a complex role in determining the pattern of neurological disorders worldwide. Determining the pattern of neurological disorders enables health policymakers to plan evidently for service, training, and research priorities. Few prevalence studies in neurology were conducted in Sudan. Methods: This is a retrospective hospital-based study that reviewed the medical records of patients who attended a Dedicated Neurology Clinic (DNC) in Omdurman, the national Capital of Sudan, for 24 months, from January 2016 to January 2018. This study aimed to determine the DNC pattern of neurological disorders as a representative subset prevalence in Sudan. Neurologists conducted the medical workup for diagnosis after at least two visits. All patients have ethically consented. Results: The total number of patients was 1050. Only 749 patients (71.3%) fulfilled the inclusion criteria. The mean age was 46.5 ± 1.9, and males were 45.3%. 72% were from the Capital. The presenting symptoms were headache (16.6%), seizures (11.5%), limbs weakness (11.2%), and lower percentages for other neurological symptoms. The commonest diagnoses were Stroke 12.4%, Epilepsy 9.3%, Primary Headache 8.8%, Movement Disorders 7.3%, Peripheral Neuropathy 6%, Dementia 4% Neuroinfections 1.4%, Demyelinating Disorders 2.6%, Spinal Spondylotic Radiculopathy 2.6% and 1.7% for Cerebral Venous Thrombosis. Conclusion: The data from Sudan-DNC showed that the most common neurological disorders descendingly were Stroke, Epilepsy, Headache, Movement Disorders, Peripheral Neuropathy, Dementia, Infections, Demyelinating Disorders, Spinal Spondylotic Radiculopathy, and Cerebral Venous Thrombosis. The demyelinating disorders and peripheral neuropathy showed a higher percentage than our previous preliminary prevalence study in 2012 compared to the other conditions, which showed similar rates in that study.

Nonalcoholic fatty liver disease and COVID-19:An epidemic that begets pandemic

Coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has become a global pandemic,affecting all the individuals across the planet.COVID-19 has gained significant attention due to its high prevalence among individuals with diabetes,nonalcoholic fatty liver disease(NAFLD),and metabolic syndrome.NAFLD is the hepatic manifestation of metabolic syndrome and can be associated with a high risk of developing type 2 diabetes.The association of COVID-19 and NAFLD has also gained more attention because NAFLD is highly associated with the epidemic of obesity.NAFLD is a potential risk factor for SARS-CoV-2 infection and severe COVID-19,independent of metabolic syndrome.Importantly,it is not yet clear whether the epidemics of obesity and NAFLD have perpetuated the current pandemic of COVID-19.Further research is urgently needed to assess the following:(1)Whether NAFLD is a high risk factor for SARS-CoV-2 infection;(2)Whether NAFLD is associated with the severe form of COVID-19;and(3)Whether the presence of NAFLD can explain the racial variation in the morbidity and mortality associated with COVID-19.This review summarizes the interactions between COVID-19 and NAFLD,mechanism of liver injury by COVID-19,and effect of lockdown due to COVID-19 on patients with NAFLD.