Hospitals In Khartoum Research Articles

Variations in Cystic Duct Anatomy Using Magnetic Resonance Cholangiopancreatography and their Clinical Significant in the Sudanese

Background: Anatomical variations of the cystic duct are very frequent, and it is substantial to be familiar with these variations preceding to any surgical, percutaneous and endoscopic intervention procedures.Objective: The aim of this study is to determine the normal (typical) and atypical anatomical variations in the cyst duct using magnetic resonance cholangiopancreatography at Fedail Specialized Hospital in Khartoum, Sudan.Materials and Methods: This study is a retrospective evaluation of the cystic duct in 307 patients who were routinely imaged with Magnetic Resonance cholangiopancreatography between November 2019 and March 2021 for various indications.Result: This study included 307 patients aged 6 months to 100 years, of whom 44.3% were male and 55.7% were female. The location, level, and course of the cystic duct were examined. The typical anatomy of the cystic duct was seen in only 30.29% of patients; this percentage is low compared to the range reported in the literature (58–75%). A total of 69.71.% showed atypical configurations. The most common variant was high cystic insertion, observed in 36.2% of cases. Low insertion was observed in 21.8%, low medial insertion in 14.6%, a spiral posterior course in 15.6%, and a parallel course in 10.1%. A short cystic duct less than 5 mm in length was seen in 1% of cases. Other rare findings include a case-for-case (0.3%): absent cystic duct; spiral anterior course with low medial insertion; spiral anterior then posterior; drainage of cystic duct to the right hepatic duct; drainage of the cystic duct at the junction between the right and left hepatic ducts; very high insertion just below the junction of the right and left hepatic ducts; and finally, a case of common bile duct cyst. The relationship between the location, height, and course of the cystic duct and gender was examined, and the result of the chi-square test showed that there was no statistically significant difference between males and females with regard to anatomical variations (p = 0.740). (p=0.671) (p=0.678).Conclusion: The normal anatomy of the cystic duct is observed in only 30.29% of cases. Anatomical variations are encountered in 69.71% of cases, with high insertion of the cystic duct being the main variation observed in 36.2% of cases; the next most common variation is a low insertion in 21.8% of cases.

Degloving soft tissue injuries of upper limbs and their management in Khartoum - Sudan: a cross-sectional study.

Degloving soft-tissue injuries are underreported in Sudan and are potentially devastating. They require early recognition and diagnosis with early and systemic management to reduce the complications that may arise, and to minimize delay for proper intervention by a multidisciplinary team that is usually needed to ensure the effective rehabilitation of these patients and a better outcome. To assess the degloving soft tissue injuries of the upper limb and their management in Khartoum. A cross-sectional hospital-based study is multicentric (Khartoum North Teaching Hospital, Association Specialized Hospital, East Nile Hospital) in Khartoum - Sudan. A study was conducted on 82 patients with degloving soft tissue injuries of the upper limbs during the period from 2021 to 2022. Patients with different age groups were included whereas patients with close degloving injuries and degloving injuries of fingers were excluded. Eighty-two patients were studied. The male-to-female ratio was 4.8:1, with a mean age of 31.5. The common (59.8%) injury site was the dominant upper limb, with 58.5% distal UL injuries. The main etiology of injury was road traffic accidents (52.4%), followed by occupational injuries (20.7%). 51.2% of the injury was a noncircumferential single-plane degloving soft tissue injury. Degloving soft tissue injuries of the upper limbs are associated with deep structure injuries in 61% of patients (bone fracture in 43.9%). Serial debridement before reconstruction as a staged procedure was done in 61% of patients. The most common reconstruction method performed was skin grafts (57.3%), followed by flaps (32.9%). Half (52.4%) of the patients developed complications postoperatively, and the most frequent complication was wound infection (23.1%). Upper limb degloving soft tissue injuries are complex life-threatening injuries that, if present late or poorly managed, lead to devastating complications ranging from local infection to major disabilities, amputation, and death.

β2_adrenergic receptor gene polymorphisms p.Gly16Arg and p. Glu27Gln in Sudanese patients with bronchial asthma: A case-control study

BackgroundSeveral reports have indicated the involvement of β2-adrenergic receptor gene (ADRB2) polymorphisms rs1042713 p.Gly16Arg and rs1042714 p.Glu27Gln in susceptibility to bronchial asthma and its clinical severity. This study investigated the genotype frequencies of these two polymorphisms in Sudanese patients with bronchial asthma, compared them to a healthy control group, and correlated the genotypes with the clinical severity of asthma. MethodsA case-control study, matched for age, sex, and body mass index (BMI) was conducted at Al-Shaab Teaching Hospital in Khartoum, Sudan, between January and April 2022. The study included fifty subjects in each arm: adults with bronchial asthma were cases and healthy individuals were controls. Genotyping for rs1042713 p.Gly16Arg and rs1042714 p.Glu27Gln was determined by allele-specific polymerase chain reaction. Adjusted odds ratio (aOR) was calculated using asthma as a dependent factor and variables like ADRB2 gene polymorphisms, age, BMI, and sex as independent factor. ResultsThe genotype GG (Gly16Gly) in the ADRB2 rs1042713 p.Gly16Arg was more prevalent in cases compared to controls (28 % vs. 10 %) and showed a significant risk effect for bronchial asthma [aOR = 3.81, 95 % CI (1.23–11.80); p = 0.020]. The allele G is more frequent in cases than controls, however it was not statistically significant [OR = 1.27, 95 % CI (0.72–2.22); p = 0.394]. For ADRB2 rs1042714 p.Glu27Gln, none of the genotypes or alleles showed any significant association with bronchial asthma. Additionally, none of the genotypes in the two gene polymorphisms were associated with the clinical severity of asthma. ConclusionIn this study, the ADRB2 rs1042713 p.Gly16Arg gene polymorphism showed a significant risk effect for bronchial asthma, while no association was observed with ADRB2 rs1042714 p.Glu27Gln, further study is needed.

Hematological picture of pediatric Sudanese patients with visceral leishmaniasis and prediction of leishmania donovani parasite load.

Visceral leishmaniasis (VL) is a systemic protozoan infection caused by Leishmania donovani (L. donovani) and transmitted by sand flies, causing macrophage invasion in the liver, spleen, and bone marrow. Diagnosis of VL is currently based on clinical signs, symptoms, and specific in-vitro markers and bone marrow investigations. However, VL's specific hematological and bone marrow manifestation in Sudanese pediatric patients is not well studied. To examine the blood and bone marrow characteristics in pediatric patients from Sudan who have VL. This is a retrospective hospital-based study with a sample of 107 consecutive Sudanese pediatric patients. The data focused on hematological and bone marrow results. We included only the completed records of the pediatric patients with VL in the Tropical Disease Teaching Hospital in Khartoum, Sudan from the period of 2016 to 2020. The majority of pediatric patients included in this study are below 5-years-old (n = 59, 55.2%). Moreover, anemia, thrombocytopenia, and leukopenia were among the prevalent characteristics in the population under study. To further analyze the data, we developed a machine learning model using boosted forest algorithms to predict L. donovani parasites load, with a mean accuracy of 0.88 for the training dataset and an accuracy of 0.46, 0.50, and 0.74 for mild, moderate, and severe L. donovani parasite load in the validation dataset. This study shows that the most common bone marrow change among Sudanese VL children was increased chronic inflammatory cells (n = 88, 82.2%) with present macrophage hemophagocytes (n = 103, 96.3%). While anemia and thrombocytopenia were the most common hematological changes. These results will hopefully lead to an early diagnosis and hence better management for Sudanese pediatric patients with suspected VL.

Health-related Quality of Life among Patients with Type II Diabetes Mellitus

Background: Diabetes mellitus is a chronic disease that causes considerable morbidity and mortality worldwide, resulting in an impaired quality of life in affected people. Aim: To assess health-related quality of life among patients with type II diabetes mellitus and its associated factors. Methods: A cross-sectional study design was conducted from January to July 2022 at Ribat University Hospital in Khartoum and Abdallah Khalil Diabetic Centre in Omdurman. A total of 400 patients with type II diabetes who visited the referred clinics were enrolled in the study. Data was collected by face-to-face interview using the revised Diabetes Quality of Life instrument to assess the health-related quality of life. Data was analyzed using SPSS version 23.0 and summarized using tables and charts. The association between health-related quality of life and sociodemographic characteristics, clinical factors and lifestyle factors was obtained using chi-square test. Results: The mean score for overall health-related quality of life was 29.3 ± 11.5 while each domain of “satisfaction”, “impact” and “worry” had mean scores of 13.7 ± 4.9, 8.5 ± 4.4 and 7.1 ± 3.7, respectively. Since the scores obtained were only approximately half of the possible range of scores for quality of life, the overall health-related quality of life is considered to be moderate. This study also revealed that 40% of the participants have poor health-related quality of life. The relationship between HbA1c level & health-related quality of life was statistically significant (P value = 0.044) in which high glycosylated hemoglobin levels was associated with poor quality of life. Gender, age, education level, marital status, duration of diabetes and the presence of comorbidities and complications had statistically significant association with health-related quality of life. Conclusion: This study demonstrates a moderate overall health-related quality of life among patients with T2DM. Besides, it also demonstrates a low quality of life among 40% of patients with T2D, suggesting that quality of life should be included in any modality used for treating diabetic patients.

Knowledge, Attitudes, and Practices of Prescribing Doctors Towards Direct Oral Anticoagulants: First Cross-sectional Study from Sudan

Background: During recent years, the prescription rates of direct oral anticoagulants (DOACs) have increased rapidly worldwide. Little is known about situation of DOACs in Sudan. Therefore, this study was conducted to assess prescribing doctors’ knowledge, attitude, and practice level regarding DOACs. Methods: A cross-sectional, hospital-based study was conducted at three large hospitals in Khartoum, Sudan. The doctors were recruited from a wide range of disciplines such as cardiology, surgery, and nephrology. A four-section questionnaire consisting of questions on demographics, knowledge, attitude, and practice was designed and administered. Results: A total of 100 doctors responded over a period of four months, 52% of them were found to correlate with a low level of knowledge. Moreover, 56% and 81% of the doctors demonstrated inappropriate attitude and practice levels, respectively. With regard to switching protocols between DOACs and warfarin, the majority of the doctors did not have sufficient information when converting from rivaroxaban to warfarin and vice versa. Conclusion: The overall knowledge, attitudes, and practices of prescribing doctors regarding the use of the DOACs were found to be inadequate and insufficient for maintaining high therapeutic outcomes in patients necessitating anticoagulants agents. A well-structured educational program about DOACs is urgently needed.

Skin disorders in patients with type 2 diabetes mellitus in Khartoum Dermatology and Venereology Teaching Hospital

Background: Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose, which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin. About 1 in 11 adults worldwide now have diabetes mellitus (DM), 90% of whom have type 2 DM (T2DM). One of the most common manifestations of diabetes are skin complications, such as dryness of the skin, bacterial and fungal infections. Objectives were to study the frequency and pattern of skin disorders in patients with T2DM at Khartoum dermatology and venereology teaching hospital (KDVTH) in Khartoum, Sudan during August 2016 to December 2016. Methods: This was prospective, observation descriptive, cross-sectional hospital-based study used a quantities method. A total convenient sample technique enrolled 100 points during the study period. Results: One hundred diabetic patients (64% male and 36% female) were included in the study. The age group varies between (25 and >70 years), the commonest cutaneous manifestations were xerosis which was found in 45 patients (45%), fungal infection found in 36 patients (36%). Serum HbA1c level was done for each case. Conclusions: The study concluded that the most prevalent cutaneous diseases among patients were xerosis fungal infection, eczema, bacterial infections, and scabies respectively. A significant relationship between duration of DM and level of HB A1C and the presence of cutaneous manifestations was observed.

Risk Factors of Rheumatic Heart Disease in a Children's Hospital in Khartoum: A Case-Control Study.

Rheumatic heart disease (RHD) is the most prevalent acquired cardiac illness in Sudan, arising as a complication of acute rheumatic fever (ARF). Additionally, Sudan exhibited a wide diversity in the distribution of RHD. The echocardiographic screening revealed 3/1000 cases in one region (Khartoum), while in another region (Nort Kordofan), it revealed 61/1000 cases. Consequently, further research is warranted to shed light on this disease, particularly its risk factors. There is a lack of research on the risk factors in Sudan. The objective of this study is to evaluate Sudan's RHD risk factors. This case-control study was conducted at Jafar Ibn Auf Children's Hospitalfrom August to December 2016. A questionnaire was used to study RHD risk factors, including socioeconomic status, maternal education and employment, housing conditions, residence, and history of sore throat and ARF. Comparison between cases and controls was estimated using conditional logistic regression with 95% confidence intervals (CI). A total of 78 participants, including 39 established RHD cases and 39 age- and sex-matched normal controls, were recruited. The age in years for cases and controls was 11.1 +/- 2.9 and 11+/- 2.9, respectively. In the univariate analysis, only the history of ARF was significantly associated with RHD (odds ratio (OR) 60.8, 95% CI10.3-356). There was a trend toward increased risk of RHD in association with a history of sore throat in 69.2% of the patients and origin from western states in 41% of the patients, but this did not reach statistical significance. ARF history and a six-month history of throat infections are linked to RHD. Mothers do not have a correlation with RHD, buta correlation exists when there is a connection between a history of ARF and a recent throat infection (effect modification). Furthermore, an association was found between throat infections and living in a western state. Consequently, it is imperative to adopt RHD prevention, particularly the prevention and treatment of both ARF and throat infections.

Assessing and Enhancing the Adequacy of Radiology Request Forms at a Tertiary Care Hospital in Sudan: A Clinical Audit.

Clinical auditing is one method of improving the quality of patient care. Radiology request forms (RRFs) are crucial for the purpose of facilitating communication between the radiologist or radiographer and the referring clinician. A two-cycle clinical audit was conducted at the Radiology Department of Atbara Police Hospital in Khartoum, Sudan. A total of 100 forms were collected, with 50 forms from each cycle. As an intervention, the existing blank paper format for radiology requests was replaced with a structured form based on the standards of the Royal College of Radiologists (RCR). This new form was distributed hospital-wide, and doctors were educated on its use through presentations and briefings. The collected forms were then compared against the RCR standards for completeness and accuracy. Data were entered into Microsoft Excel 2016 for analysis. The interventions led to notable improvements in several areas. Accuracy in recording the patient's address, phone number, and location increased from 0 (0%) in the first cycle to 50 (100%) in the second cycle, marking a 100% improvement. In addition, referencing the patient's age improved from 15 (30%) in the first cycle to 50 (100%) in the second cycle, indicating a 70% increase. The mean score for RRF documentation was 25.33% in the first cycle and significantly increased to 97.77% in the second cycle. The audit shows significant improvement in RRFs post-intervention, highlighting the importance of standardization. However, deficiencies point to the need for orientation and follow-up training for physicians to ensure accurate form completion. Integrating quality assurance, including periodic audits and real-time feedback, can help sustain these gains. Collaboration between radiologists and referring physicians is also essential for ongoing improvement.

The Significance of TNF-α, CRP, and Hematological Parameters in the Prediction of Plasmodium Falciparum Parasitemia

Malaria remains a significant public health concern in Sudan, with Plasmodium falciparum (P. falciparum) infection having widespread indirect consequences. Effective identification of infection severity is crucial for preventing complications. This study aimed to assess the predictive value of Tumor Necrosis Factor Alpha (TNF-α), C-reactive protein (CRP), and hematological parameters in P. falciparum parasitemia. The three-month cross-sectional study involved 54 P. falciparum-positive patients at Bashaire Teaching Hospital Khartoum, Sudan, along with an equal number of P. falciparum-negative individuals. Participants underwent Antigen Rapid Diagnostic Test (RDT), TNFα, CRP, and Complete Blood Count (CBC) assessments. The infected group comprised 68.5% male patients, with a mean age of 22.3 years. Significant variations were observed between the infected and uninfected groups in TNFα, CRP, Total White Blood Cells (TWBCs), and neutrophil levels, with infected individuals showing higher values. Conversely, infected individuals had lower hemoglobin, Red Blood Cells (RBCs), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), platelets, and lymphocytes. The study revealed a noteworthy association between MCV and parasitemia, while TNFα, CRP, Hb, RBCs, MCH, and MCHC showed no significant correlation. Hematological parameters should be considered in malaria patients.

Antibiotic resistance in Sudan: assessing the knowledge and practices of healthcare workers in Khartoum.

Antibiotic resistance (ABR) is a major public health issue, associated with increased patient morbidity and mortality globally, with significantly higher rates in low- and middle-income countries (LMICs). Assessment of contextual factors, such as information, education, infrastructure and regulations are important for developing local solutions against ABR. To determine the knowledge and practices of healthcare workers (HCWs) towards ABR in hospitals in Sudan. A survey was conducted in three different hospitals in Khartoum, Sudan from February to December 2020. HCWs of different specialties and expertise were invited to participate. Data were descriptively analysed using Statistical Package for Social Sciences (SPSS). ABR was identified as a big challenge by 89% of 345 HCWs who participated. The results show that 79% of doctors don't rely on the clinical microbiology laboratory (CML) results for antibiotic prescription or clinical decision-making. Sixty percent of HCWs agreed there are infection prevention and control (IPC) guidelines in their hospital, but 74% of them don't have access to them, and infrequently receive relevant IPC training. Furthermore, HCWs obtain ABR information from other colleagues informally, not through local data or reports. Despite adequate knowledge of ABR locally, there are significant contextual technical challenges facing HCWs in Sudan, such as availability of policies and accurate data from CMLs. The results indicate a poor link between HCWs and the CMLs for infection management and it is essential to improve communication between the different hospital departments with regard to ABR transmission, and ensure the effectiveness of local IPC policies based on locally available data.

Knowledge and Practice of Metered-Dose Inhalers (MDIs) Among Asthmatic Patient in Al-Shaab Hospital In Khartoum 2018

Knowledge and Practice of Metered-Dose Inhalers (MDIs) Among Asthmatic Patient in Al-Shaab Hospital In Khartoum 2018

Heterophoria, fusional vergence, and near point of convergence in Sudanese hospital-based population

Background: Fusional vergence amplitude is the amount of convergence and divergence that can be induced before fusion is lost and fusional vergence amplitude controls heterophoria.Aim: This study aimed to investigate the relationship between near heterophoria, near fusional vergence (NFV), and near point of convergence (NPC).Setting: Al-Neelain Eye Hospital Khartoum, Sudan.Methods: A hospital-based prospective study from February to October 2019, included 230 patients with age range of 15–30 years and mean age and standard deviation of 19.46 ± 3.33 years. The alternate cover test with prism was used to measure near heterophoria and a prism bar was used to measure quantity of fusional vergence. All measurements were taken at near heterophoria (0.33 m). Then the associations between near heterophoria, NFV and NPC were assessed.Results: The most common heterophoria at near among the participants was exophoria: 200 (87.0%). Reported complaints of asthenopia were commonly found among these exophoric patients: 106 (86.9%) (P = 0.735). Positive fusional vergence (PFV) to the break point varied according to the forms of heterophoria (P = 0.003). Esophoria had a higher PFV to break point than exophoria (30.83 ± 8.79Δ compared to 25.59 ± 10.07Δ). Negative fusional vergence at the break and recovery points were higher among those with exophoria and lower in esophoria (P ˃ 0.05). The NPC differed by the type of heterophoria (P = 0.01), with exophoria and slightly receded NPC (8.38 cm ± 3.33 cm) than for participants with esophoria (6.77 cm ± 1.52 cm).Conclusions: Exophoria was the most common type of near heterophoria, with asthenopia being the most reported complaint. Esophoria was found to be strongly associated with high PFV. Exophoria, on the contrary, is related to significant high NFV at the blur, beak, and recovery point. The NPC differed significantly by the type of near heterophoria, with exophoria having more receded NPC compared to those with esophoria.Contribution: This study provides information on the commonest type of near heterophorias among a sample of Sudanese adolescents and young adults, namely exophoria. Near point of convergence and NFV at break and recovery points were significantly different according to forms of near heterophoria.

The Needs of Patients With Chronic Disease in Transitional Care From Hospital to Home in Sudan: A Qualitative Study.

The growing burden of chronic non-communicable diseases demands improved post-discharge care. The Sudanese healthcare system faces challenges in providing coordinated care for patients with chronic conditions after hospital discharge. This qualitative study explored the experiences of patients with chronic disease in transitional care from hospital to home to identify improvement targets. Purposive sampling was used to interview 17 participants from different hospitals in Khartoum, Sudan. Audio recordings were transcribed and analyzed using principles of content analysis to identify themes and the relationship between them. Thematic analysis revealed 4 main themes describing the perceived needs of the patients. These were (1) feeling well-informed about post-discharge care goals and plans; (2) feeling cared for during hospital admission and follow-up visits; (3) feeling safe during the transitional care process; and (4) having access to follow-up services. This study highlights the importance of improving hospital patient education through effective communication to facilitate care transitions.

Radiation dose assessment: Establishment of local diagnostic reference levels for selected radiography examinations across three prominent hospitals in Sudan

Due to variation among radiographers’ practice, and the importance of unifying practice during radiography for optimizing radiation level and image quality, the current manuscript aims to assess the radiation dose level and propose local diagnostic reference levels (LDRL) for posterior-anterior (PA) chest, antero-posterior (AP) abdomen, and pelvis examinations in two hospitals in Khartoum (‘K’) and one hospital in Wad-Medani (‘M’) cities, Sudan. Along with patient demographics like height and weight, the radiation exposure parameters including tube potential, current, and radiation duration were documented. This included 732 patients whose tests were conducted at one of three departments located in two different cities. The entrane surface air kerma (ESAK) was calculated using DosCal software and an Unfors -Xi-meter. The average ESAK for an X-ray of the chest was 0.18 mGy in M, 0.19 mGy in K (averaged over two hospitals in the K), for the abdomen it was 1.1 and 1.23 mGy, and for the pelvis it was 1.8 and 01.9 mGy respectively. The proposed DRL was achieved from the third quartile of radiation dosage of data, and it was 0.21, 1.7 and 1.9 mGy for the chest, abdomen and pelvis respectively. There was a wide variation in dosage levels among the three hospitals. The current proposed DRL was lower than most literature for the chest, abdomen and pelvis. More studies are recommended for other examinations such as skull and contrast media studies.

Traditional uvulectomy; practice and belief among Sudanese children in Khartoum hospitals: A multi-center cross-sectional study

BackgroundTraditional healing practices are common in Sub-Saharan Africa. Traditional uvulectomy (TU) is the removal of the uvula with a sharp curved knife and is often practised in children under five years old. This practice is believed to have a therapeutic effect on children suffering from sore throat, vomiting or difficulty breastfeeding. ObjectivesThis study aimed to describe the practice of traditional uvulectomy and Sudanese mothers’ perception of it. MethodsA cross-sectional study was conducted in seven teaching hospitals across Khartoum State. We interviewed 385 mothers of children who presented to pediatric units using a semi-structured questionnaire. The study period spanned from July 2022–February 2023. ResultsA total of 385 mothers of children under five participated in this study. 33 % of mothers believed in the practice of traditional uvulectomy, yet only 17.9 % of children under five years had undergone TU. Reasons for performing TU included persistent cough (36.9 %), vomiting (33 %), difficulty in breastfeeding (22.6 %) and TU being a family tradition (25.7 %). Factors significantly associated with these practices were the mother's age, her level of education and the family's regional origin. Mothers reported that no major complications to the children were perceived as a result of the TU procedure. ConclusionThe practice of TU is prevalent among children who present to hospitals seeking medical advice. More than one-third of mothers had misconceptions regarding the uvula. Health education campaigns targeting females of childbearing age, and health practitioners at primary health centres and hospitals must raise awareness related to this practice.

The ABCDE approach: Evaluation of adherence in a low-income country

BackgroundEarly recognition and initial treatment of trauma patients prevents deterioration and buys time for making a definitive diagnosis. The “Airway, Breathing, Circulation, Disability and Exposure” (ABCDE) approach should be used whenever an injury is suspected. It provides quick identification and management of life-threatening problems. Still, there is limited knowledge regarding adherence to the ABCDE approach. This research aims to assess the adherence of the trauma team members to the ABCDE approach in the management of major trauma patients and the factors affecting it. MethodThe study is a cross-sectional hospital-based study conducted in the trauma and resuscitation rooms of major governmental hospitals in Khartoum in the period from Jan.30, 2022, to Mar.29, 2022. It was done among the medical staff dealing with major trauma cases. Data were collected by observation using a modified standardized checklist for assessing the ABCDE approach and via a self-administered questionnaire for identifying the factors affecting adherence. Total coverage of all major trauma cases resuscitation (n = 50) was done. Also, a sample size of 158 medical staff was covered for the questionnaire. The data was analyzed in Statistical Package for the Social Science (SPSS) V.23. ResultsThe mean percentage of adherence to the ABCDE approach was 37.9 % (SD 15.44). When the ABCDE sequence was not followed, the ACB was the commonest sequence. Also, adherence had no significant relation with any patient or staff-related factor. The main present obstacles to adherence to the ABCDE approach were overcrowding in the room and unprepared facilities. While the major present facilitator was the clinical experience. ConclusionThe adherence rate was low, but initiation of the ABCDE approach was rapid. The factors participating in low adherence rates were usually facility or population-based factors. We recommend further studies, further training and embedment of guidelines, and the provision of larger trauma rooms with adequate supplies.

Awareness and Practice of Febrile Convulsions First Aid Among Parents of Convulsing Children Admitted to Hospitals in Khartoum 2022

Introduction: Febrile convulsion (FC) is a convulsive episode accompanied by fever in children under five years old. It is a common cause of hospital admissions and can induce fear and anxiety among parents and caregivers. Educating parents and caregivers about FC first aid and home management is crucial to alleviate these concerns. Objectives: This study aimed to assess the awareness and practice of FC first aid among parents of convulsing children admitted to hospitals in Khartoum. It also aimed to determine the socio-demographic data of parents, evaluate their knowledge about FC, assess their practices towards convulsing children, and correlate them with age, socioeconomic status, level of education and recurrence of FC. Methodology: A cross-sectional hospital-based study was conducted on 288 participants from Ibrahim Malik Teaching Hospital, Turkish Hospital, Ahmed Gasim Hospital for Pediatric, Omdurman Hospital for Children, and Albuluk Hospital. Results: The study included 219 mothers (76%), 36 fathers (12.5%), and 33 others (11.5%). Less than half of participants were between 20-30 years old (46.9%), 59% had a medium socioeconomic status, and 37.8% had a secondary level of education. Regarding knowledge about FC, 57.3% of participants had average knowledge, 17% had poor knowledge, and 25.7% had good knowledge. However, when it came to practice, the majority exhibited poor practice (89.9%), with only 10.1% demonstrating average practice. The study also found a correlation between the knowledge and practice of parents with their age, educational level, and income. However, there was no significant association with recurrence of FC. Conclusion: The study emphasizes the need for improved education and awareness among parents and caregivers regarding FC first aid and home management. There is a gap between knowledge and practice, highlighting the importance of targeted interventions and educational programs to enhance the care and management of convulsing children.

Sociodemographic distributions and molecular characterization of colonized Enterococcus faecium isolates from locality hospitals in Khartoum, Sudan.

Enterococcus faecium is an opportunistic pathogen of humans with diverse hosts, encompassing animals as well as human beings. In the past twenty years, there has been a rise in the instances of nosocomial infections that are linked to antibiotic-resistant Enterococcus faecium. The acquisition of diverse antimicrobial resistance factors has driven the global development of robust and convergent adaptive mechanisms within the healthcare environment. The presence of microorganisms in hospitalized and non-hospitalized patient populations has been significantly aided by the facilitation of various perturbations within their respective microbiomes. This study aimed to determine the antimicrobial profile, demographic and clinical characteristics, along with the detection of virulence encoding genes, and to find out the clonal genetic relationship among colonized E. faecium strains. A hospital-based cross-sectional study was carried out between October 2018 and March 2020 at four Khartoum locality hospitals in Sudan. The study comprised a total of 108 strains of E. faecium isolated from patients admitted to four locality hospitals in Khartoum. A self-structured questionnaire was used to gather information on sociodemographic traits. Data were analyzed using chi-square test. In all cases, P value ≤ 0.05 with a corresponding 95% confidence interval was considered statistically significant. Moreover, enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) was utilized to assess the prevalence of clonal relationships, and the gel was analyzed using CLIQS software. In this study, the isolation rate of colonized E. faecium strains was 108/170 (63.5%). The colonization of E. faecium and its association with various sociodemographic and clinical features was examined. 73 (67.6%) of patients had multidrug-resistant (MDR), and 22 (20.4%) had extensively drug-resistant (XDR), 73 (67.6%) of patients engaged in self-medication practices. Eighty patients (74.1%) were non-adherence to prescribed antibiotics, while 70 (64.8%) patients reported recent antibiotic usage within the 3 months. The present study suggests that demographic factors may not be significantly associated with the incidence of E. faecium infection except for patients who had a prior history of antibiotic use (P≤0.005). The analysis of virulence genes showed a high prevalence of asa1 gene (22.2%) among strains. In ERIC-PCR the genetic relatedness of E. faecium showed seven identical clusters (A-G) with 100% genetic similarity. This implies clonal propagation in hospitals and communities. This study found that the incidence of E. faecium isolated from locality hospitals in Khartoum was likely due to the spread of E. faecium clones, thereby highlighting the need for intensifying infection control measures to prevent the spreading of nosocomial infection.

Detection of Methylene Tetrahydrofolate Reductase (MTHFR C677T) Mutation among Acute Lymphoblastic Leukemia in Sudanese Patients.

A genetic polymorphism that causes abnormal folate metabolism may lead to genomic instability and increase susceptibility to malignancies such as Acute Lymphoblastic leukemia (ALL). The purpose of this research is to identify methylene tetrahydrofolate reductase (MTHFR C677T) (NCBI ID: 4524) mutation in ALL patients. The study was a descriptive case-control hospital-based study with one hundred Sudanese participants divided equally into fifty (50) Sudanese ALL diagnosed patients as cases and fifty (50) Sudanese individuals as controls. The MTHFR C677T mutant allele was detected using conventional PCR, with the primer sequence of MTHFR C677T F-TGAAGGAAGGTGTCTGCGGGA R-AGGACGGTGCGGTGAGAGTG. The study was conducted from January to March 2023, and samples were collected from the Radiation and Isotops Center at Khartoum Hospital. The investigation revealed that 12 of the 50 patients in the case group (24%) had the MTHFR C677T mutant allele, and the study also revealed that there is significant correlation with the control group. There is no significant relationship between socio-demographic variables and MTHFR mutation detection in ALL patients. Also, the sociodemographic variables predictors of MTHFR mutation among ALL patients adjusted for smoking habit revealed no significant relationship. According to the findings of this study, the mutant allele of the Methylene Tetra Hydro Folate Reductase C677T was detected and demonstrated varying degrees of significance. It was concluded that the MTHFR C677T gene mutation was associated with acute lymphoblastic leukemia in Sudanese patients.