Khartoum Teaching Hospital Research Articles

Publications in Plastic Surgery and Reconstruction: A Review from a Developing Country, Sudan.

Plastic and reconstructive surgery services need to be improved in developing African countries. Research and article publications from those countries are limited. This review was conducted to identify published articles from Sudan in the area of plastic and reconstructive surgery. This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were used for the preparation of this systematic review. A comprehensive systematic search was performed using PubMed, ScienceDirect, and Web of Science databases. Articles published in Sudan, specifically in the area of plastic and reconstructive surgery, and written in English were included in this review. The total number of articles that fulfilled the inclusion criteria was 23. The articles were written from 1969 to 2023. Only two articles were published in the 20th century. The most common study type was a retrospective study of eight articles, and the most common study area was Khartoum Teaching Hospital. Regarding the publishing journals, the number of subscription journals was six (30%), whereas open access was 17 (70%). This review demonstrates the lack of articles published on plastic surgery in Sudan. Further investigation is needed to determine the challenges and problems associated with possible clarifications.

Odontogenic Keratocysts: Presentation and Surgical Outcome in a Sample of Sudanese Patients.

Odontogenic keratocyst (OKC) is a benign intraosseous lesion relatively frequent in the oral cavity. It has a locally aggressive behavior and exhibits a high propensity to recur after treatment. The present study aimed to investigate the clinicoradiographic presentations and outcomes of surgical treatment of OKC at Khartoum Teaching Dental Hospital. Material and Methods. Fifty-five cases of OKC files at the Department of Oral and Maxillofacial Surgery in Khartoum Teaching Hospital between 2012 and 2022 were reviewed and studied using a descriptive prospective cross-sectional study. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 27. Out of 55 cases studied, the mean age at the time of diagnosis was 30 ± 17.6 years; of them, 28 (50.9%) were males and 27 (49.1%) were females. The most common clinical manifestation was swelling (34.9%), followed by pain (28.0%). Sixty-five percent of the OKCs were located in the posterior mandible, and multilocular radiolucency (73.6%) was the most prevalent radiological finding. Enucleation with Carnoy's solution (CS) (55.2%) was the most common surgical modality that was used in more than half the patients, and only six patients had a recurrence. Marsupialization and segmental resection had no recurrence, while marginal resection and curettage had the highest recurrence rate of 20%. Patients with consanguineous parents had a higher recurrence rate (15%) compared with patients who had nonconsanguineous parents (8.6%). None of the patients died or had a malignant transformation. The most common location for the cyst was the mandible, and multilocular radiolucency was the most prevalent radiological finding. Enucleation with CS was the most commonly used surgical modality, used in more than half of the patients, with only six patients experiencing recurrence.

Indications of Intrapartum Blood Transfusion among Sudanese Women

Background: little attention has been given in the literature to the problems of intra partum blood transfusion, but many hospitals note that they make a substantial contribution to good maternal outcome. Intrapartum blood transfusion is life saving and reduce maternal mortality. Objective: The main objective of the study was to determine indications, incidence and risk factors of intra partum blood transfusion among Sudanese women. Methodology: It was a descriptive prospective cross-sectional hospital-based study conducted in Khartoum teaching hospital during period May 2012 - October 2012. An interview questionnaire was used for data collection. The data was collected by trained doctors in the labour room. Two hundred and forty (240) pregnant women received blood intra partum were included in the study after an informed consent. Data was collected by structure questionnaire. Demographic and clinical data concerning personal history, risk of blood transfusion, type of blood and preparation of were recorded Results: Total the deliveries during period of the study were 6813, and 240 of the women received a blood transfusion so the rate of blood transfusion was 4%. The mean age and parity of the women who received blood transfusions were 27.6 years, and two respectively.

The Assessment of Nursing Staff Knowledge and Barriers Regarding Aseptic Techniques in Khartoum Teaching Hospital, Sudan.

Background Aseptic techniques are crucial in preventing healthcare-associated infections, which are an integral part of standard precautions, and encompass a range of practices designed to safeguard patients from healthcare-associated infections. Objective The objective of this study was to evaluate the level of knowledge and identify the barriers faced by nursing staff in implementing aseptic techniques. Methodology This study employed a stratified random sampling technique to ensure the representation of the research sample. A cross-sectional, descriptive research design was used to assess the knowledgeand barriers of nursing staff in maintaining aseptic techniques in their medical practice at Khartoum Teaching Hospital, Sudan. The nursing staff members were divided into different units, and a proportionate number of participants were randomly selected from each stratum. A total of 83nursing staff members were recruited for this study. Data collection was conducted using a structured questionnaire specifically designed for this study. The questionnaire consisted of items that assessed the nursing staff's knowledge and barriers to aseptic techniqueimplementation. Results The study findings revealed that the mean knowledge score of nursing staff was 14.12, with a median score of 15. The knowledge score had a standard deviation of 3.22. Approximately two-thirds of the nurses (66.3%) had an average level of knowledge, while 33.7% had a below-average level of knowledge. The chi-square analysis indicated a significant association between educational level, years of experience, and knowledge scores (P value=0.010)at a significance level of 0.05. Additionally, 65% of the participants reported facing multiple challenges in maintaining aseptic techniques, including insufficient training, limited resources, and inadequate support. Conclusion In conclusion, the evaluation revealed that a significant proportion of participants felt that their unit lacked adequate training and resources for aseptic techniques. Many had observed colleagues not adhering to aseptic practices, and the participants faced multiple challenges in maintaining aseptic techniques, including insufficient training, limited resources, time constraints, and inadequate support.

Sinonasal masses: modalities, clinical presentation, and management in Sudan

BackgroundSinonasal masses are not an uncommon spectrum of diseases. They are frequently encountered in Sudan, sometimes with variability in modalities across the country. The objective of this study is to document the pattern of sinonasal masses in Sudanese patients and to highlight the knowledge of the modalities, clinical presentations, and management. As a consequence, this will raise awareness especially of the general practitioners and family physicians and hence the community locally and regionally. Early diagnosis and appropriate management can reduce the rate of recurrence, fatal complications, and hence morbidity and mortality.MethodsThis is a prospective descriptive, comparative hospital-based study conducted from January 2020 to January 2021. All patients with sinonasal masses, who came to Khartoum ENT Teaching Hospital seeking medical advice during the above-mentioned period were included in the study provided they satisfy the inclusion criteria. Enrollment was optional with the right to withdraw at any time. Consent was verbal with the reassurance about the aspect of confidentiality, privacy, and consent of the data. Ethical clearance was obtained from the ethical committee (EDC) SMSB and from the research committee of Khartoum teaching hospital. Analysis was done using a computer and the statistical package of social sciences SPSS V.25ResultsA total number of 244 patients were studied. The age group of 21–40 years was the most encountered with the disease (42.6%). Two hundred three patients (83%) had a non-neoplastic disease, (9%) benign neoplastic lesions, and (8%) malignant neoplastic lesions. The non-neoplastic group was dominated by nasal polyposis of which the fungal were the most common (50%). Among benign neoplastic lesions, pyogenic granuloma ranked first (24%). Among malignant neoplastic lesions, squamous cell carcinoma dominated the epithelial origin lesions (71%) and Rhabdomyosarcoma dominated the connective tissue cell types (50%). Nasal obstruction is the most common complaint (94.7%) followed by nasal discharge (64.8%) then anosmia (53.3%). Endoscopic surgery was done in (84.4%) of patients, combined approach endoscopic and open surgery in (5.3%) while open surgery alone was done in 2.5%. Radiation and chemotherapy were used in 2% each, while chemo-radiation was used in (2.5%). The rest of the cases (1.3%) were managed by surgery followed by chemoradiation.ConclusionPatients with sinonasal masses in Sudan especially the age group 21–40 years must be seen in specialized Otolaryngology clinics to pick, diagnose and treat significant diseases in an early stage. Radiology and histopathology are a must in sinonasal swellings to diagnose malignant diseases at an early stage. Nasosinus fungal polyposis being the commonest in non-neoplastic lesions, the commonest among all sinonasal masses added together, and a known reported endemic disease in the country must receive special consideration and investigation for early diagnosis and treatment.

Assessment of Clinical Profile and Impact of Different Risk Factors among Scabietic Children at Khartoum Teaching Hospital

Assessment of Clinical Profile and Impact of Different Risk Factors among Scabietic Children at Khartoum Teaching Hospital

Pregnancy and commonly usage hematological medications in Sudan

Background: When a woman with hematological issues considers pregnancy, she may need to take drugs. Objectives: This research looked into the use of hematological drugs to treat illnesses like anemia. Methods: This is a descriptive retrospective cross-sectional hospital-based study which carried out in Military Hospitals and Khartoum Teaching Hospital (Sudan) from Jan 2014 - Jan 2015. Data collection form was used to extract the information from 650 pregnant patient files. The information recorded included: age, trimester, medical history and hematological drugs. Results and Discussion: Four hundred & forty two (N=442=68%) of the women had normal (75-90%) hemoglobin, and 208 (32%) were below normal (40-70%) hemoglobin. Four hundred & thirty one (66.3%) of the pregnant women were dispensed hematological medications and the consumption was significantly higher in the third trimester (7-9 months) 89.6% of women (N = 386) than the second trimester (4-6 months) 10% of women (N = 43) and the first trimester (1-3 months) 0.46% of women (N = 2).

Prevalence of Cardiovascular Drugs Among Pregnant Women in Sudan

Background: Pregnant women with heart disease present multiple medical dilemmas. Pregnancy-related physiological changes impair the heart's ability to respond to pathological processes such as hypertension and heart failure. Aim: The current study's aim is to elicit data on cardiovascular medication use during pregnancy. Methods: This is a descriptive, retrospective, cross-sectional, hospital-based study, carried out in Military Hospitals and Khartoum Teaching Hospital, in Sudan. A data collection form was utilized to gather information from 650 patient files of pregnant women. Results: 650 subjects met the study criteria; 7% of women (N=46) were dispensed cardiovascular medications, the consumption being significantly higher in the third trimester (7-9 months) in 78.26% (p<0.05). The most common cardiovascular drugs dispensed were Methyldopa (N=26, 4.0%), Heparin (N=9, 1.3%), Nifedipine (N=7, 1.0%), Hydralazine (N=2, 0.3%) and Diazepam (N=2, 0.3%). Methyldopa is the commonest in the all trimesters - first (1-3 months) (N=2, 0.3%), second (4-6 months) (N=4, 0.6%) and third (7-9 months) (N=20, 3.0%). Nifedipine and Diazepam were used only in the third trimester. Conclusions: There are many clinical situations requiring cardiovascular medications in pregnancy. Thus, it is necessary to conduct frequent health educational programs educating pregnant women about the risk factors for pregnancy-induced cardiovascular disease, and proper use of medication. Keywords: Pregnant Women, Cardiovascular Medications, Hypertension, Methyldopa

INFECTION CONTROL: STANDARD PRECAUTION MEASURES KNOWLEDGE, ATTITUDE AND PRACTICE OF MEDICAL DOCTORS AND NURSES IN SUDAN

Background and objectives: The emergence of life-threatening infections has highlighted the need for effective infection control programs in all health care settings. These programs are used to support hospitals in reducing the risk of healthcare-associated infection or nosocomial infection, and this study describes the knowledge, attitude, and practice (KAP) of standard infection control precautions among Health Care Workers in 3 teaching hospitals in Sudan. Methods: A cross-sectional study was conducted between March and August 2018 among healthcare workers in 3 teaching hospitals: Omdurman Teaching Hospital, Khartoum Bahri Teaching Hospital and Khartoum Teaching Hospital in Sudan. Data for 254 nurses and 283 working physicians were collected via a self-structured questionnaire to assess the KAP core components of standard precautions. The percentage of professional knowledge and practice scores was calculated and occupational differences in the average professional knowledge and practice scores were ascertained. Result: A total of 429 out of 537 participating healthcare workers completed the questionnaire with a response rate of (79.9%), of whom (52.9%) were physicians and (47.1%) were nurses. (39.6%) of doctors and (53.5%) of nurses have a good level of knowledge, about (96%) of doctors and (97%) of nurses wash their hands after handling any bodily fluids, and this indicates that nearly And the doctors have a similar level of practice as well as a positive attitude. (91.1%) of doctors and (85.6%) of nurses think that they can be the source of transmission. Conclusion: Based on the findings of our study, the majority of nurses had good knowledge compared to fair knowledge physicians, with positive attitudes and practices of both physicians and nurses towards the infection control program. Policies that promote training of health care workers in standard precautions and ensure that infection control and prevention resources in health facilities are regularly provided are required in Sudan. Peer Review History: Received: 7 September 2021; Revised: 9 October; Accepted: 28 October, Available online: 15 November 2021 Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Dr. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, shmahe@yemen.net.ye Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Similar Articles: SURVEY OF SAFETY PRACTICES IN DIARRHEAL TREATMENT CENTERS: CHOLERA TREATMENT CENTERS IN YEMEN PREVALENCE OF CYTOMEGALOVIRUS IGG ANTIBODIES, POTENTIAL RISK FACTORS AND AWARENESS OF CONGENITAL CYTOMEGALOVIRUS AMONG FEMALE DOCTORS

Perceived consequences of healthcare service decentralization on access, affordability and quality of care in Khartoum locality, Sudan

BackgroundDecentralization of healthcare services has been widely utilized, especially in developing countries, to improve the performance of healthcare systems by increasing the access and efficiency of service delivery. Experiences have been variable secondary to disparities in financial and human resources, system capacity and community engagement. Sudan is no exception and understanding the perceived effect of decentralization on access, affordability, and quality of care among stakeholders is crucial.MethodsThis was a mixed method, cross-sectional, explorative study that involved 418 household members among catchment areas and 40 healthcare providers of Ibrahim Malik Hospital (IBMH) and Khartoum Teaching Hospital (KTH). Data was collected through a structured survey and in-depth interviews from July–December 2015.ResultsAccess, affordability and quality of healthcare services were all perceived as worse, compared to before decentralization was implemented. Reported affordability was found to be 53 and 55% before decentralization compared to 24 to 16% after decentralization, within KTH and IBMH catchment areas respectively, (p = 0.01). The quality of healthcare services was reported to have declined from 47 and 38% before decentralization to 38 and 28% after, in KTH and IBMH respectively (p = 0.02). Accessibility was found to be more limited, with services being accessible before decentralization approximately 59 and 52% of the time, compared to 41 and 30% after, in KTH and IBMH catchment areas respectively, (p = 0.01).Accessibility to healthcare was reported to have decreased secondary to facility closures, reverse transference of services, and low capacity of devolved facilities. Lastly, privatized services were reported as strengthened in response to this decentralization of healthcare.ConclusionsThe deterioration of access, affordability and quality of health services was experienced as the predominant perception among stakeholders after decentralization implementation. Our study results suggest there is an urgent need for a review of the current healthcare policies, structure and management within Sudan in order to provide evidence and insights regarding the impact of decentralization.

Colorectal Lesions among Sudanese Patient Attending for Endoscopy-multi Center Study

Background: Colorectal cancer is one of the most significant causes of cancer death. With records of high incidence and late detection of the disease in Sudan, and it was found to affect younger age groups.Methods: This study aimed to explore the incidence of colorectal lesions in the main endoscopic centers in Khartoum state- Sudan. It was a cross-sectional prospective study; data were collected from patients attending the main endoscopic centers in Sudan- Khartoum state during February 2013 to June 2014 including Khartoum teaching hospital, Neelain medical diagnostic center and Ibn sina hospital. Results: One hundred and six participants were diagnosed endoscopically with colorectal lesions, 44 (41.5%) showed inflammatory mucosa, 40 (37.7 %) showed tumor and 22 (20.7%) had polyps. In the whole group of patients the mean age was 45.7 years, 34.2% of tumor patients were less than 50 years old, 46.8% of the lesions were in the rectum, the highest frequency of tumor patients group were from western tribes, and the lesions were located commonly in the rectum. Conclusion: We concluded that the rectum is the most common site of cancer within the Sudanese population than other parts of the colon with apparently high incidence within young ages.

A study of phyllode tumors, pathological parameters, and clinical correlations

Objectives Phyllode tumors (PTs) represent a unique entity as mixed fibroepithelial tumors of the breast, which are characterized by a particular histologic appearance, and biologically by frequent local recurrence and low metastatic potential. We aim to study patients with PTs to determine the different histopathological features regarding, tumor grade, margin, hemorrhage, heterologous differentiation, and clinical correlations regarding age, sex, site, local recurrence, and distant metastasis in Sudanese patients. Materials and methods This descriptive retrospective study was carried out on PT specimens obtained from the Pathology Department at National Health Laboratory (NHL), Soba University Hospital (SUH), and Khartoum Teaching Hospital (KTH) during the interval between January 2008 and December 2011. Clinical data were collected from patients’ request forms. The slides were reexamined by two histopathologists using WHO classification of PTs, 2012. The data were analyzed using Statistical Package for Social Sciences. Results The study included 59 specimens diagnosed as PTs. After reexamination of the slides, two cases were excluded, one being a spindle-cell sarcoma and another being a fibroadenoma. The age of the patients ranged from 18 to 80 years. The most common affected age group was 21–40 years. The mean age was 35±1.75 years, and all of them were females. The tumors were found to occur with an equal propensity in either breast. In total, 18 (35.3%) cases were considered histologically benign, 28 (54.9%) cases were considered malignant, and five (9.8%) cases were classified as borderline. Pushing margins were present in all the cases, except three histologically malignant cases, in which the margin was infiltrative. A statistically significant positive relationship was present between tumor grade and presence of hemorrhage (P<0.05). Tumor size was significantly related to histological grade also (P<0.04). However, an insignificant relation was present between local recurrence and tumor grade (P<0.065). Heterologous mesenchymal differentiation was present only in histologically malignant cases. Regional lymph-node involvement was not detected in any of the studied cases. Conclusion In our study, PTs occurred exclusively in females, commonly in the age group 21–40 years, the mean age in our study was 35 years, which is 5 years younger than the mean age reported in the literature, with no reporting of cases below 18 years. Malignant lesions outnumbered the benign lesions. Heterologous differentiation, hemorrhage, large tumor size, and infiltrating tumor margin are positively related to histologically malignant cases. Local recurrence was not significantly related to malignant phenotype, it may reflect the importance of adequate surgical margin.

Comparison of Chromogenic (HiCrome Urinary Tract Infection Agar) Medium with Cysteine Lactose Electrolyte Deficient Agar in a Resource-Limited Setting.

Background and Objectives:Urinary tract infections (UTI) are one of the most frequent infections encountered in hospital settings as well as in community, making urine the most cultured specimens in laboratories across the world. Urine samples occupy most of the time and manpower in the form of resources in the microbiology laboratories. The microbiological performance of HiCrome UTI agar was compared with cysteine lactose electrolyte deficient (CLED) agar for isolation and presumptive identification of bacteria from urine culture with ease of reporting with less human resource and reduction in the cost.Materials and Methods:The study was conducted in a total of 208 collected midstream catch urine samples from patients attending the Department of Microbiology, Khartoum Teaching Hospital Central Laboratories. Urine samples received in the bacteriology laboratory were inoculated on CLED agar and for HiCrome UTI agar simultaneously and incubated overnight. Isolates were identified by the colony's color for HiCrome UTI agar and by standard microbiological techniques for CLED agar.Results:Out of 208 urine samples tested, significant growth was obtained in 94 (45.2%) plates of CLED agar and 84 (40.4%) of HiCrome UTI; moreover, 15 (7.2%) and 28 (13.5%) plates showed mixed with no growth observed in 99 (47.6%) and 96 (46.1%) on CLED agar and HiCrome UTI agar, respectively. The rate of presumptive identification was found significantly higher on HiCrome UTI agar (94%) than CLED agar (84%) (P < 0.05) as the primary urine culture medium. out of 43 (100%) polymicrobial growths 28 (65.1%) were demonstrated distinctly on HiCrome UTI agar and only 15 (34.9%)were obtained fromCLED agar.Conclusions:HiCrome UTI agar was found to be more useful as a primary urine culture medium in both higher rate of isolation and presumptive identification of uropathogens in comparison to conventional media. Its inherent characteristics in demonstrating polymicrobial growth and ease of rapid identification by distinct colony color are unique.

EVALUATION OF NURSING CARE FOR PATIENT WITH PERITONEAL DIALYSIS IN KHARTOUM TEACHING HOSPITAL (2011)

EVALUATION OF NURSING CARE FOR PATIENT WITH PERITONEAL DIALYSIS IN KHARTOUM TEACHING HOSPITAL (2011)

التوافق النفسي لمرضى الهيموفيليا المترددين على العيادات الخارجية في مستشفى الخرطوم التعليمي وعلاقته ببعض المتغيرات The Psychological Adjustment of Hemophilia Patients attending outpatient clinics at Khartoum Teaching Hospital and its relationship to certain variables

هدفت الدراسة الحالية إلى التعرف على السمة المميزة للتوافق النفسي لمرضى الهيموفيليا المترددين على العيادات الخارجية بمستشفى الخرطوم التعليمي، والعلاقة بين التوافق النفسي ومتغير السکن لدى مرضى الهيموفيليا، استخدمت الباحثة المنهج الوصفي التحليلي، شملت عينة الدراسة (60) فردا من مرضى الهيموفيليا من الذکور بمستشفى الخرطوم التعليمي، تم اختيارها بالطريقة العشوائية البسيطة، تم استخدم مقياس التوافق النفسي، واستخدام اختبار(ت)، تحليل التباين الأحادي One Way ANOVA، أسفرت نتائج الدراسة عن أن التوافق النفسي لمرضى الهيموفيليا يتسم بالانخفاض، کما أسفرت عن وجود فروق ذات دلالة إحصائية في التوافق النفسي لصالح المرضى المقيمين بالخرطوم، وبناء على ما توصلت اليه الدراسة من نتائج وضعت الباحثة مجموعة من التوصيات أهمها: الاهتمام بالمحاضرات والندوات التي تتناول التوافق النفسي مرضى الهيموفيليا، الاستفادة من وسائل الإعلام في زيادة توعية المجتمع بأهمية الصحة النفسية لدي جميع شرائح المجتمع. کما قدمت أيضا بعض المقترحات منها: توفير الخدمات الصحية لمرضى الهيموفيليا بصورة مجانية، دعم ومساعدة المرضى الذين يأتون من الولايات إلى العاصمة لتلقي العلاج وتوفير الخدمات الصحية الطارئة لهم The study aimed to identify the characteristic of the psychological adjustment of hemophilia patients. And uncovering the relationship between psychological adjustment, and the housing variable in hemophilia patients., the researcher used, the descriptive analytical method, including the sample of the study (60) male of hemophilia patients, at Khartoum Teaching Hospital Selected with a simple random way, the researcher using the psychological compatibility scale, the test was used (T), single contrast analysis one way anova, the results of the study resulted in the psychological compatibility of hemophilia patients characterized by decrease, the presence of statistically significant differences in psychological compatibility in favor of individuals Patients living in Khartoum, based on these results, the researcher developed a set of recommendations, the most important of which are: attention to lectures and seminars dealing with psychological compatibility of hemophilia patients, utilizing the media in increasing the awareness of society about the importance of psychological compatibility in all segments of society. Proposals were also made: free health services for hemophilia patients, support and assistance to patients who come from the states to the capital for treatment and emergency health services

Exploring the consequences of decentralization: has privatization of health services been the perceived effect of decentralization in Khartoum locality, Sudan?

BackgroundThe health system of Sudan has experienced several forms of decentralization, as well as, a radical reform. Authority and governance of secondary and tertiary health facilities have been shifted from federal to state levels. Moreover, the provision of health care services have been moved from large federal tertiary level hospitals such as Khartoum Teaching Hospital (KTH) and Jafaar Ibnoaf Hospital (JIH), located in the center of Khartoum, to smaller district secondary hospitals like Ibrahim Malik (IBMH), which is located in the southern part of Khartoum. Exploring stakeholders’ perceptions on this decentralisation implementation and its relevant consequences is vital in building an empirical benchmark for the improvement of health systems.MethodsThis study utilised a qualitative design which is comprised of in-depth interviews and qualitative content analysis with an inductive approach. The study was conducted between July and December 2015, and aimed at understanding the personal experiences and perceptions of stakeholders towards decentralisation enforcement and the implications on public health services, with a particular focus on the Khartoum locality. It involved community members residing in the Khartoum Locality, specifically in catchments area where hospital decentralisation was implemented, as well as, affiliated health workers and policymakers.ResultsThe major finding suggested that privatisation of health services occurred after decentralisation. The study participants also highlighted that scrutiny and reduction of budgets allocated to health services led to an instantaneous enforcement of cost recovery user fee.Devolving KTH Khartoum Teaching and Jafar Ibnoaf Hospitals into peripherals with less. Capacity, was considered to be a plan to weaken public health services and outsource services to private sector. Another theme that was highlighted in hospitals included the profit-making aspect of the governmental sector in the form of drug supplying and profit-making retail.ConclusionsA change in health services after the enforcement of decentralisation was illustrated. Moreover, the incapacitation of public health systems and empowerment of the privatisation concept was the prevailing perception among stakeholders. Having contextualised in-depth studies and policy analysis in line with the global liberalisation and adjustment programmes is crucial for any health sector reform in Sudan.

Serum Levels of Interferon Gamma INF-γ and Interleukin 10 Il-10: an Immunological Aspect among Irritable Bowel Syndrome Patients.

The pathophysiological mechanisms of irritable bowel syndrome are controversial and the exact mechanism that play role in exaggeration of symptoms is mysterious. As an altered immunological functions in IBS patients may play role to study pro and anti-inflammatory cytokines among the study population. The aim of this study is to examine the serum cytokines of IL 10 and INFγ profile among a group of IBS patients and control. A cross sectional prospective study was conducted among 40 participants, who were referred to gastroenterology out patients clinics at Khartoum Teaching Hospital, Khartoum State, Sudan. Five milliliters blood were collected in EDTA tubes for measuring levels of cytokines in serum. Cytokines were measured by ELISA-MSD (Meso Scale Discovery). They were measured according to the manufacturer's instructions and expressed as pg mL-1. Optical density was measured at a wavelength of 450 nm and a reference wavelength of 590 nm. Out of 16 (40%) male and 24 (60%) female, their age group range between 20-70 years old. The majority of them 21(52.5%) in age group (31-50) years old. Overall IBS patients showed significantly increased (p = 0.0001) of INF-γ (29.50±17.98 vs. 6.9±1.724 pg mL-1) between patients and control, respectively. The serum levels of IL-10 was significantly higher in patients with IBS compared with control group (p = 0.001). There is an abnormal immune regulation, supporting the presence of immune activation in IBS.

Pathological and clinical profile of hearing loss among Sudanese children attending the Khartoum Teaching Hospital.

Background:Hearing loss is a common disability affecting nearly 360 million people in the world and 75% of cases live in developing countries. Many children are vulnerable to diseases causing hearing loss that often go untreated. The aim of this study is to identify the possible etiological factors and clinical presentations of children who presented with hearing loss at the Khartoum Teaching Hospital.Materials and Methods:a descriptive, cross-sectional hospital-based study. A total of 100 (response rate of 94%) children aged 5–15 who presented with hearing loss at Khartoum Teaching Hospital were included in this study. A detailed structured, pretested, and pre-coded questionnaire was used. After data collection, hearing examination was performed by an E.N.T specialist, then audiometry performed to diagnose hearing loss and for classification of the hearing loss type. Discriptive Statisistics frequencies and cross-tabulation were done. A Chi-square test was used for proportions. A P value of less than 0.05 considered significant.Results:Out of 100 patients, 68 patients (68%) belonged to the 5–10 years age group. The mean age was 8.5 years. The male to female ratio was 1.00–1.13. Conductive hearing loss was found in 66% of the studied group, sensory-neural hearing loss in 23% and the mixed type in 11%. Regarding the etiology, otitis media was found in 41 of patients (41%), congenital hearing loss in 22% (22 patients), traumatic hearing loss in 4%, sickle cell anemia in 2%, mumps in 14%, diabetes mellitus in 3%, and measles in 8% of the patients. In conclusion, a number of preventable causes were shown to contribute significantly to the etiology of hearing loss.Conclusion:The commonest factors associated with hearing loss among participants were otitis media and hereditary causes, respectively. Further community-based studies of hearing-impaired children are necessary for planning effective preventive and curative programs.

Does kangaroo mother care improve preterm infant's temperature?

Abstract: Kangaroo mother care is a method of care of preterm infants (before 37 completed weeks of gestation). The method involves infants being carried, usually by the mother, with skin-to-skin contact. This improves stability of preterm infant temperature. The aim of the study: To investigate the effect of kangaroo mother care on preterm infant’s temperature in a neonatal intensive care unit at the Khartoum teaching hospital - Sudan. Methodology: The study design was Nonequivalent Groups Design (a pretest-posttest randomized experiment), 120 mother-preterm infant pairs were selected through purposive sampling. Subjects: The target population for this study were all medically stable preterm infants who were admitted to the neonatal intensive care unit at the time of the study. Preterm infants of gestational age 30–36 weeks (n=120), 60 intervention groups received KMC and another 60 were control group received conventional care. The researcher was available five days per week, five hours per day from 9 am to 2pm. The average number of cases that was taken per week ranged from8 to 10 premature infants and their mothers. Setting: This study was conducted in neonatal intensive care unit (NICU) in Khartoum teaching hospital. Tools: The tools of study divided into two tools; Tool I: Questionnaire was used to collect the demographic data related to preterm infants and their mothers in the intervention and control group, and auxiliary temperature before and after kangaroo mother care for intervention group and also done for control group in conventional care. Tool II: Mercury thermometer. The results: Independent–sample t test was calculated and showed that there is a significant difference regarding the mother's age, and preterm infant weight (P-value = .06 & . 00) Respectively. And there is no significant difference regarding preterm infants gestational age, and preterm infants age since birth (P-value = .82 & . 50) respectively. Mothers' educational level the majority were secondary school, (40.83%), and the lowest were intermediate school (11.67%). The majority of preterm gender were male (60%), and the other was female (40%). Regarding preterm infant's temperature, independent–sample t test showed that there is no significant difference between intervention and control group before KMC (P-value = .86). And there is a significant difference between intervention and control group after KMC (P-value = .01). Paired sample test investigate that, there is a significant difference regarding the level of temperature for intervention group before and after KMC (P-value:. 000). Conclusion: KMC was effective and positively promoted premature infant's temperature than those cared by the conventional care. Recommendation: Educational training program for all neonatal nurses in skills necessary to implement the KMC and further studies should be conducted to assess the neonatal nurses' knowledge, attitudes and practices regarding KMC. Abbreviations: Skin to Skin Contact (SSC), World Health Organization (WHO), Kangaroo Care (KC), Neonatal Intensive Care Unit (NICU), Kangaroo Mother Care (KMC), Gestational Age (GA). Keywords: kangaroo mother care, preterm infants, temperature.

Epidemiological Pattern of Injuries Resulting from Road Traffic Accidents in Khartoum, Sudan

Background: Traffic accidents are increasingly becoming a threat to public health and national development in many developing countries. Sudan isn’t an exception, the number of vehicles is rapidly increasing while the road’s widths remain as same as before, so many accidents took place, and serious losses and damages to both human beings and vehicles may occur. This study was aimed at identifying the epidemiological pattern of injuries and determinants that contribute to road traffic accidents (RTA) in Khartoum Teaching Hospital Sudan. Methodology: Hospital based descriptive study was conducted in Khartoum Teaching Hospital. 150 road traffic victims who attended the emergency room or were admitted to the hospital from February-May 2012 and fulfilled the inclusion criteria were included in the study. A pre-test standardized administered questionnaire was used for data collection. Results: Males were more affected (85%); laborers were the highest among the victims (43%). Sixty three of RTA causes were related to the drivers. Conclusion: Urgent intervention is needed through the involvement of many sectors and specialties. There is an urgent need to setup a database to collect, store and analyze information related to road traffic accidents. This will help the authorities to plan strategically for appropriate interventions across the country.