Wad Madani Research Articles

Multiple gridded‐based precipitation products' performance in Sudan's different topographical features and the influence of the Atlantic Multidecadal Oscillation on rainfall variability in recent decades

AbstractThe selection of a reliable long‐term rainfall dataset is deemed appropriate for hydroclimatic assessments, especially in regions with limited distribution of rain gauge stations like Sudan. The study presents an initial investigation for gridded‐based rainfall products and satellite‐based products over Sudan using standardized statistical methods. Overall, the monthly evaluation revealed reasonable statistical agreement with in situ observations. Seasonal analysis shows that summer rainfall is detected more accurately than yearly rainfall, especially in mountainous areas across the country. Generally, underestimation was observed in all products over most regions on an annual, seasonal, and monthly scale, respectively. Results for the Taylor skill score (TSS) indicated relatively low skills for ECMWF Reanalysis 5th Generation (ERA5), moderate to strong skills for Climate Research Unit (CRU) and Climate Hazards Group Infrared Precipitation with Stations (CHIRPS), against the reference rain gauges among the regions. The regional comparison using TSS when considering monthly and seasonal timescales showed CHIRPS and CRU had the highest performance with an average percentage of 89.6 and 92% in the west (Nyala, Al Geniena, and Al Fasher), 89 and 84.6% at the central part (Khartoum, Wad Madani, and Al Obied), and 92.5 and 86.5% in the south (Al Damazine and Kadogli). At 95% confidence level, a significant increasing trend was observed over the highlands at the centre (Al Obied) and western areas (Al Geniena and Nyala), while most stations showed positive trends. Further analysis on temporal correlation with Atlantic Multidecadal Oscillation (AMO) demonstrated a strong correlation between the AMO PC1 and JJAS rainfall PC1 (82%). The west recorded the highest response to AMO (90%), while the east had the lowest response (74%), with the north, central, and south obtaining 77, 76, and 76%, respectively. Our findings provide useful information about rainfall in Sudan, suggesting CHIRPS data for monitoring rainfall variability and extreme events which should encourage its use in areas with scarce stations.

Evaluation of Thyroid Uptake of 99mTc Pertechnetate Using Gamma Camera and Dose Calibrator Methods in the Sudanese Population

Background: Estimation of the thyroid gland volume is generally considered important in several pathologic situations. The main objective of this study was to evaluate the thyroid uptake (TU) of 99mTcO4- in Sudanese people, using gamma camera and dose calibrator methods and comparing the results with international TU levels. Methods and Results: The study was conducted in 2020 at the National Cancer Institute (Wad Madani state, University of Gezira, Sudan). This study included 64 patients (58 females and 6 males) aged 13-81 years (37.25±14.58 years) with normal TU. Most patients (43.8%) were in the age subgroup of 31-48 years, followed by 39.1% in the age subgroup of 13-30 years.Two calibration methods were used to calculate full and empty syringes before and after radiopharmaceutical injection: a) using a dose calibrator measuring in MBq; b) with gamma camera images of the full and empty syringes for 1 minute (counts). In the dose calibrator, the activity and time of a 99mTc point source in a syringe were monitored, the point source was precisely aligned with the center of the camera, and a static image was obtained with static parameters at a distance of 5cm and 7cm between source and pinhole collimator (265×265 matrix). The study showed that the TU values using the dose calibrator method were more consistent with radiation protection principles of minimizing the exposure to radiation for staff. The method also had higher values than those measured with a gamma camera due to the scatter radiation. The relationship between TU of 99mTcO4- with syringe measured by dose calibrator and gamma camera at a distance of 5cm and 7cm, given a coefficient of determination (R2) of 0.9937 and 0.9591, respectively Conclusion: There was no big change in the TU between the two methods, especially at 5cm object-to-pinhole distance, where it gave the best result for optimum imaging in the 99mTcO4- TU test.

MATERNAL AND FETAL OUTCOME OF POSTDATE PREGNANCY IN WAD MADANI MATERNITY TEACHING HOSPITAL, GEZIRA STATE, SUDAN

Background: Post-term pregnancy by definition isa pregnancy that reaches 42 weeks of gestation or more. Post term pregnancy leads to an increased risk to the fetuses and neonates and increase their mortality and morbidity as well as an increased maternal morbidity Objective: To study maternal and fetal outcome of postdate pregnancy in Wad Madani maternity teaching hospital, Wad Madani, Gezira State 2020 Materials and Methods: Observational, descriptive cross-sectional hospital-based study was conducted in Wad Madani maternity teaching hospital which located in Wad Madani city, Gezira state in central zone of Sudan within the period from March to September 2020 and covered postdate pregnant women. Data was gathered, processed and analyzed using SPSS. Results: Study included 102 postdate pregnant women. Nearly half of them 49 (48%) were 30 – 39 years in age with mean age of 31.2 ± 8.4 years. Most of them 74 (72.5%) were from urban residential areas, 69 (67.7%) were educated until secondary school level or above, 65 (63.7%) housewives and 61 (59.8%) were from low socioeconomic status. Clinically, 48 (47.1%) were multipara. Only 61 (59.8%) of them had regular antenatal care follow up. Also, 14 (13.7%) were obese, nine (8.8%) had positive past history of postdate pregnancy and three (2.9%) had positive family history of postdate pregnancy. Concerning the maternal outcome, the study found that caesarian section was 31 (30.4%), while 11 (10.8%) instrumental delivery, and 60 (58.8%) were delivered with vaginal delivery. The most common maternal complications were obstructed labour six (5.9%), followed by perineal tear, postpartum haemorrhage three (2.9%) and sepsis five (4.9%). No maternal mortality was reported. Blood transfusion was needed for 18 (17.6%) of them. Regarding the fetal outcome, female gender was reported in 54 (52.9%) of neonates, only seven (6.9%) were less than 2.5 kg while seven (6.9%) were more than 4 kg. Most neonates 92 (90.2%) were alive, nine (8.8%) stillbirth, one macerated stillbirth and no congenital malformation was reported. Moreover, low Apgar score (< 6) was reported in 11 (10.8%), meconium aspiration syndrome was four (3.9%), IUGR seven (6.9%) and RDS weretwo (2%).11 (12%) were admitted to NICU and only one (9.1%) were dead. Conclusion: Based on the study results, we concluded that postdate pregnancy is vulnerable for considerable undesired maternal and fetal outcomes which should not be ignored. Therefore, the relevant preventive and curative measured should be implemented as a priority for this risky group of pregnant ladies in Sudan.

Is low adiponectin concentration linked to the development of type 2 diabetes in Sudan

Objectives: It was previously thought that adiponectin influenced insulin activity in tissues. Insulin resistance caused by obesity is associated to reduced plasma adiponectin levels. Researchers may be able to better understand the role of adiponectin in insulin resistance and type 2 diabetes by comparing adiponectin levels in T2DM patients to non-diabetic patients, as well as its connection with BMI and WC. Method: A case-control study was conducted at the Abu A'gla Health Care Center for diabetes care in Wad Madani, Gezira State, Sudan, between April 2012 and March 2013. The study involved a total of 181 participants. To measure adiponectin, FPG, and HbA1C levels, patients were divided into diabetes and non-diabetic groups. The body mass index (BMI) was calculated, and the waist circumference (WC) was measured. Personal information (age and gender) were obtained. Samples were analyzed for many biochemical parameters using the A15, a random-access auto-analyzer bio system. To quantify adiponectin, ELIZA employed the techniques of a human adiponectin ELISA kit. A statistical software for social sciences was used to conduct the statistical analysis (SPSS version 16, Chicago, IL, USA). Result: The mean BMI (29.007) increased significantly between diabetic and non-diabetic groups (p=0.001) indicating that the study participants were overweight. There was significant increased (p<0.0001) in FPG (160.10) and HbA1C (6.9813) and non- significant decreased in adiponectin mean (1.567) concentration. SBP and DBP mean (116.52) and (75.51) were significantly low (p=0.006) and (0.054), respectively. Conclusion: Adiponectin levels were lower in diabetic and non-diabetic patients. Only two diabetics had excessive quantities. Adiponectin and BMI were thought to have an inverse relationship, with no association between adiponectin and WC.

Seroprevalence of herpes simplex virus type-2 among pregnant women in Wad Madani-Sudan: a cross sectional study

Background: Sexually transmitted diseases are known to pose a significant public health threat. Herpes simplex virus type 2 (HSV-2) is a viral infection with high prevalence in Sudan, particularly among pregnant women. The aim of this study was to determine the seroprevalence of HSV-2 among pregnant women as well as their associated potential risk factors in Wad Madani-Sudan. Methods: In total, 92 pregnant women who attended the Maternity Hospital and Dr. Altigani Sedeeg Fertility Center at Wad Madani, AL-Gezira State, between April and August 2018 were included in this study. HSV-2 Immunoglobulins (IgG and IgM) were assayed by the enzyme-linked immunosorbent assay technique. Results: The seroprevalence of HSV-2 IgM and IgG were 35(38%) and 90(97.8%), respectively. A Higher prevalence of HSV-2 IgG 45(48.9%) and 13(14.1%) for IgM was detected in pregnant women aged 15-24 years old with a significant association between HSV-2 IgM and age distribution group (p-value=0.001). HSV-2 IgM and IgG seropositivity were highest in the first trimester; 26(34.2%), and 75(81.5%), respectively. The highest rate of HSV-2 IgM was detected in 19 (20.7%) women with a history of abortion, while the highest rate of HSV-2 IgG was seen in 50 (54.3%) women without a history of abortion. The statistical analysis results did not reveal significant differences between gestational stages and history of abortion with the presence of HSV-2 antibodies. Conclusion: The prevalence of HSV-2 was significant among pregnant women in Wad Madani- Sudan. There was a strong association between HSV-2 IgM seropositivity and the age of pregnant women.

Efficacy of Pethidine in the Treatment of Postoperative Shivering on Elective Caesarean Section Patients at Wad Madani Maternity Teaching Hospital, Gezira State, Sudan

Shivering is one of the most common complications of neuraxial blockade. Some patients find shivering sensation worse than surgical pain post-operatively. Therefore, both prevention and treatment of established shivering should be regarded as clinically relevant interventions during the preoperative period. This prospective experimental study was conducted at Wad Madani Maternity Teaching Hospital and aimed to measure the efficacy of pethidine when used for the treatment of postoperative shivering following spinal anesthesia during the period from November 2018 to February 2019. The sample size included of 40Patients within the American Society of Anesthesia type two physical statuses;25 mg pethidine diluted in 5 ml Normal saline-injected intra veins. All patients were monitored for temperature, heart rate, blood pressure, and oxygen saturation, these parameters were recorded preoperative, and post 10 minutes of operative, then after 10 minutes of pethidine dose administration. Data were analyzed by using a statistical package for social sciences (SPSS). The statistical results showed that there was a significant relationship between hypothermia and the presence of shivering. 90% of cases resolved to shivering, whereas 10% did not resolve, just 2.5% had Nausea and Vomiting and no side effects on the Respiratory and cardiac Systems. Based on those results the study concluded that: a small dose of pethidine 25 mg intra veins is very effective in resolving postoperative shivering with minimum side effects in the gastrointestinal tract and Good Cardiopulmonary stability. The study recommended that: warming tools should be available for patients to prevent heat loss, close monitoring of Patient's temperature intraoperative and in the recovery room, and use of 25mg Pethidine in the Presence of shivering intraoperative or post-spinal anesthesia.

Appraisals of Sero-detection of Treponema pallidum Antibodies IgG and IgM and CBC parameters among Spontaneous Recurrent Miscarriage in Women- Case-Control Study in Gezira State 2018

Objectives: We determined Sero-detection of Treponema pallidum (IgG and IgM antibodies) using ELIZA techniques women with recurrent Miscarriage in Gezira state and appraisal of other risk factors.
 Methods: in this case-control, a hospital-based study conducted at Wad Madani teaching hospital Department of Obstetrics gynecological, Gezira State, Sudan. Ninety subjects were involved, 45 were women with recurrent Miscarriage, and controls were healthy pregnant women (no miscarriage). Serum Treponema pallidum antibodies were estimated by the ELIZA method.
 Results: Sero-detection of IgG and IgM antibodies by using ELIZA techniques, a total of 45 miscarriage women (cases) for IgM 6 (13.3%) were positive, and 39 (48.8%) were negative for Treponema pallidum by using ELISA techniques. A total of 45 non-miscarriage women (control) for IgM 4 (8.9%) were positive, and 41(91.1%) were negative For Treponema pallidum by using ELISA techniques. A total of 45 miscarriage women (cases) for IgG 13(28.9%) were positive, 32(71.1%) were negative. Furthermore, IgG for non-miscarriage, like IgM 4(8.9%), was positive, and 41(91.1%) were negative.
 Conclusion: Higher prevalence of Treponema pallidum IgG seropositivity among pregnant women who reported miscarriages compared to those who did not report miscarriages (p < 0.001) while no association between IgM seropositivity and pregnant women who reported miscarriages.

Frequency of Isolation and Antibiotic Resistance Patterns of Bacterial Isolates from Wound Infections, National Cancer Institute, Wad-Medani, Sudan, 2021

Background: Disturbance of skin integrity (wound) provides a suitable environment for the growth and multiplication of bacteria. The emerging occurrence and spread of multidrug-resistant microbial pathogens present a significant challenge in providing effective health care and is, therefore, a worldwide medical issue. Aim: The current study reports on the occurrence of possible pathogens associated with wound infections at National Cancer Institute, Wad Madani, Sudan. Methodology: This was a cross-sectional descriptive, hospital-based study including 100 patients with wounds suspected to be infected. Suspicion was dependent on the inability of wounds to heal properly. A structured questionnaire was given to the subjects to acquire demographic information (age, gender, marital status) and the history of antibiotics administration. Wound swabs were collected and processed according to standard procedure and isolated bacteria were tested for their antimicrobial susceptibilities through the disc diffusion technique according to the CLSI guidelines. Results: Morphological identification revealed that the percentage of gram-positive cocci among the isolates was: S. Aureus (66%), and Streptococci (34%). On the other hand, gram-negative bacilli included the following: E coli (48.1%), Proteus vulgaris (19%), Proteus mirabilis (14%), Klebsiella species (9%), Pseudomonas species (5%) and other bacterial species (4%). Most bacterial isolates exhibited a high rate of resistance to cephalosporin generations (Cefixime (69%), Cefuroxime (49%), Cefotaxime (32%), Ceftriaxone (29%), Cefepime (20%)). The majority of bacterial isolates were sensitive to Meropenem (resistance rate 3%). The antibiogram results of the other antibiotics were as follows: Ciprofloxacin (18%), Gentamicin (16%). Conclusion: S. Aureus was the most prevalent bacteria among the isolates with a percentage of 66%. The highest rate of resistance was observed among cephalosporin generations, mainly Cefixime and Cefuroxime with resistance rate of 69% and 49%, respectively.

Assessment of G6PD Activity among Diabetic Patients and Its Relationship with Hyperglycemia, Wad Madani, Gezira State, Sudan

Assessment of G6PD Activity among Diabetic Patients and Its Relationship with Hyperglycemia, Wad Madani, Gezira State, Sudan

A Study on Pulmonary Tuberculosis and Risk Factors in New and Re-Treated Presumptive Patients at Wad Madani Tuberculosis Center, Sudan (2018-2019): A Cross-Sectional Study

Introduction: The increase in cases of drug-resistant pulmonary tuberculosis, especially in endemic areas, is mainly associated with re-treatment, although resistant tubercle bacilli can be easily transmitted between all susceptible persons. Objective: The study aimed to describe pulmonary tuberculosis, risk factors and MDR in new and re-treated suspected patients attending Wad Madani Tuberculosis Center that provides service in central Sudan. Methods: Cross-sectional laboratory based study among 300 presumptive pulmonary tuberculosis patients during 2018 and 2019 was conducted. Cases were divided into new and re-treated. Mycobacterium tuberculosis DNA and rpoB gene of multi-drug resistance (MDR) were detected in sputum samples by GeneXpert assay as manufacturer instructions. Results: Out of 300 suspected participants, 34% (103/300) were diagnosed as pulmonary tuberculosis using GeneXpert method. The frequency of males, the age group from 21 to 40 and rural housing were the most with percentage reach 68% (70/103), 51% (53/103) and 58.3% (60/103) respectively. All observed symptoms were significantly associated with pulmonary tuberculosis. New cases represented 59.2% (61/103) while re-treated was 40.8% (39/103). The overall frequency of MDR patients was 9.7% (10/103) of which 50% (5/103) had relapse situation. Conclusion: It appeared that the cases of MDR pulmonary tuberculosis are on the increase compared to previous findings, recommended measures must be taken to control the spread of tuberculosis and the causes of re-treatment and relapse must be studied.

Diagnostic Performance of glmM Gene and Histological Stains for Detection of <i>Helicobacter pylori</i> in Gastric Biopsy from Patients Admitted to Wad Madani Teaching Hospital, Sudan

Helicobacter pylori is the microbial agent most responsible for gastro-duodenal ulcer and chronic gastritis, which can develop into carcinoma of the stomach. This study was performed in Wad Medani Teaching Hospital, Sudan to detect Helicobacter pylori in stomach samples, and evaluate the performance of the tests used, which were histological stains and PCR. Gastric biopsies were obtained from 105 referred patients during endoscopy, and fixed specimens examined by haematoxylin-eosin and Warthin-Starry silver stains, while DNA was extracted for glmM gene amplification. Epigastric pain was the most common symptom at 78% (82/105) and chronic gastritis recorded with 71% (68/105) of endoscopy results. Warthin-Starry silver stain gave 31% (33/105) as positive for Helicobacter pylori followed by glmM gene 27% (28/105) and haematoxylin-eosin 24% (25/105). The study indicated good performance of histological staining and high specificity of glmM gene in detection of Helicobacter pylori from gastric biopsies.

Implementation of Antibiotic Guidelines in a Dental Teaching Hospital in Sudan

Dental professionals routinely use root canal treatment (RCT) worldwide to treat pulpal and periapical infections. Antibiotics are overprescribed for RCT patients with little regard to the prescription guidelines, as documented in many recent studies; this results in irreversible effects on public health. This study measures dental students' knowledge at the University of Gezira (UoG) for the most current American Dental Association (ADA) guidelines and assessing their relative compliance with these guidelines. Material and Method: This a cross-sectional study conducted among fourth and fifth-year students (142) at the Faculty of Dentistry at the UoG, using a multi-sectional questionnaire. The questionnaire consists of sections that evaluate the students' knowledge of the 2019 ADA guidelines, implement these guidelines, and students' opinions regarding bacterial resistance and the curriculum of the dental schools in Sudan. Results: 41.6% of the students' responses regarding the 2019 ADA guidelines were wrong, 30% of all the prescribed antibiotics for RCTs in Wad Madani dental teaching hospital were not in line with the recent guidelines. 81% reported a lack of knowledge about antibiotics prescription guidelines among dentists and dental students in Sudan, and 87% said there is a need to refine the curriculum of dental schools in Sudan. Conclusion: There was a lack of familiarity among dental students about the 2019 ADA guidelines and the incomplete implementation of these guidelines in RCTs; there is a need to refine dental education, clinical systems, and legislation to minimise unnecessary antibiotics prescriptions.

Medication Adherence and Affecting Factors among Type Two Diabetic Patients, Attending Al-Daraga Health Center, Wad Madani Al Kubra, Gezira State, Sudan, (2020)

Type II diabetes mellitus and its complication are becoming more prevalent in Sudan. The most important predictor of reduction of morbidity and mortality due to diabetes complication is the level of glycemic control achieved. In Sudan diabetes mellitus (DM) is common public health problem, in 2017 about 12% developed serious complications. This study aimed to identify the general characteristics of type II diabetic patients, relevant diabetic characteristics duration, treatment, control and complications. Also to determine level of adherence, and reason behind non adherence medications. A cross-sectional study of randomly selected 360 patients of type II diabetic patient that attend at Al-Daraga Health Center, Wad Madani,Al Kubra locality, Gezira state ,during period from September – October 2020, found that there's statistically significant showed the relation between marital status, socioeconomic status, level of education , Occupation and factors affect adherence in taken medications at ( p value less than 0.05) also There’s significant relation between causes with patients not adhered to used medications (p value 0.000), The socioeconomic status contributed factors in diabetes mellitus complication because the low income level about 213(59.2%). Type II diabetic patients was associated with higher glycated hemoglobin seen among younger age groups. It is also showing the important of Group discussion with the patients to increase awareness of adhering to treatment plan. This study will be helpful in providing evidence regarding the importance of adherence should be emphasized and empowered within the diabetic population.

The Prevalence and Factors associated with Burnout among Sudanese Health Care Professionals at Primary Health Care Centers in Wad Madani Al-Kubra (Sudan), and Sharjah (UAE), 20 October – 20 November 2020

Burnout has long been recognized as a major problem among healthcare professionals and has become much more prevalent in the last decades. Beside healthcare professionals, it also negatively impacts the quality of health care services and patients. To identify the prevalence and factors associated with burnout among health care professionals at primary health care center in Wad Madani Al-Kubra (Sudan) and Sharjah (UAE). This is a comparative, analytical, cross-sectional health facility-based study conducted in primary health care (PHC) at Wad Madani Al-Kubra (Sudan) and Sharjah (UAE). The study assessed burnout among (75 participants in Wad Madani) out of 77 health care professionals with response rate of (97.4%), as well as it assessed (75 participants in Sharjah) out of 86 health care professionals with response rate of (87.2%). For assessment of burnout, the study calculated its prevalence and grade using method of evaluation modified from Maslach Burnout Inventory. All participants whose score was >10 out of 30 considered as positive for burnout. Low, moderate and high burnout was reported for cases score (<10, 11-20, 21-30). Chi-Square test was used for calculation of significance at P value < 0.05 and 95% CI. The data was analyzed by using Statistical Package for Social Sciences (SPSS, ver. 25). Females in Wad Madani & Sharjah groups were (82.7% and 77.3% respectively).Prevalence of burnout in Madani and Sharjah groups was reported with a considerable percentage (45.3% and 57.3%), (P value = 0.096). Low burnout was reported in 52(69.3%) for each of Wad Madani and Sharjah group. High burnout was reported in only 3 participants in Wad Madani group. Burnout is significantly higher among females when compared to males (57.5% vs. 26.7% respectively, P = 0.002). Burnout is significantly increase within increasing in number of patients met per day. The prevalence rate of medical personnel burnout in Alsharja primary health centers, UAE was found slightly higher than Wad Madani group, but no a statistically significant difference between the two groups. Recognition of burnout by health authorities and putting measures to rectify it.

Knowledge, Attitude and Practice of Diabetic Patients Towards Foot Care at Al-Daraga Health Center, Wad Madani Al Kubra Locality, Gezira State, Sudan, (2020)

Background: The incidence of foot ulcers ranges from 8% to 17 % [Crawford F, Inkster M, Kleijnen J, Fahey 2007]and others like peripheral neuropathy, peripheral arterial disease. Objectives: The aim of the study is to identify the knowledge, attitude and practice of diabetic patients on foot care. Patients and Methods: Across-sectional study of randomly selected 360 patients of diabetic patients that attend at Al-Daraga Health Center, Wad Madani, Al Kubra locality, Gezira state, during period of one-month 2020. Data was collected via face-to-face interviews by using questionnaire and analyzed by (SPSS). Results: The results showed that there is excellent knowledge about diabetes complications, complications (94,4%), and that there is high knowledge of taking medications regularly to prevent complications (82.2%), about practicing such as washing feet daily and changing socks daily. Consultation of doctors when any symptoms appeared were good with knowledge more than 50% of each. But there's lack of knowledge by more than 50% for things such as washing the feet by warm water with water temperature checked, and dried feet after washed. There is a lack of practicing with more than 50%, about things such as checking the feet daily and checking the shoes before wearing. Conclusion: Not only good knowledge is needed for footcare, but also good attitude and practice are needed. It is necessary to firstly develop awareness of diabetes and the related complications one amongst which is footcare. Certain educational strategies should be established for both doctors and the patients. I recommended establishing a program like group discussion to patients towards footcare. This study will be helpful in providing evidence regarding the importance of foots care and empowered within the diabetic population.

Anatomical Structure of the Umbilical Cord in Sudanese and Correlation with Neonatal Outcome

Background The neonatal morbidity and mortality is very high in the Sudan, the umbilical cord association and contribution to this is planned to be answered. Therefore the present study was designed to provide some information on the morphological variations of human umbilical cord via gross anatomical assessment and their correlation with foetal factors such as foetal weight and length. Methods A prospective hospital - based study conducted in Wad Madani Maternity Teaching Hospital Department of Obstetrics and Gynecology between July 2014 and March 2018 Results The mean diameter of the 371 umbilical cords was 2.1±0.24cm. Length was 53.8±3.8 cm length ranging from 48 – 62 cm and 10 (2.7%) of 371 umbilical cords were uncoiled. of which, 1 (0.3%) cords were with absent Wharton’s Jelly. The mean neonatal indices were 2.95 kg, 33.19 cm and 44.42 cm for weight, head circumference and length respectively. There was just significant strong positive correlation between umbilical cord length and length of neonates. Also Umbilical cord diameter had a positive correlation with length of neonates and negative correlation with weight of neonates and APGAR Score. Conclusion The present study suggests that ‘normal’ cord length should be between 40 cm and 70 cm in length. Umbilical cord diameter had a positive correlation with fetal length and negative correlation with fetal weight and APGAR score. The diameter range of 1-2 cm suggests that a normal cord must not exceed 2 cm in diameter. However the umbilical cord index had negative correlation with length of neonates.

Frequency and Antimicrobials Susceptibility Pattern of <i>Staphylococcus aureus</i> Associated with Wound Infections in Surgery Department, Wad Madani Teaching Hospital, Sudan

Background: Most community and hospital acquired infections are due to Staphylococcus aureus, these infections involve both local suppurative and systemic conditions. There is an increase in the incidence rates of acquiring resistant strains of Staphylococcus aureus in hospitals and community in Sudan. This study aims to detect frequency of Staphylococcus aureus isolated from surgical-sites infections (SSIs) and traumatic wounds, and to determine susceptibility to commonly used drugs. Methods: Prospective cross-sectional laboratory based study was followed, 250 patients admitted to Surgery Departments at Wad Madani Teaching Hospitals during 2019 and 2020 were recruited; with clinical manifestation of SSIs and or/traumatic wounds. Swab sample was taken from each participant and incubated aerobically on mannitol salt agar. Biochemical tests and 16rRNA gene used for Staphylococcus aureus identification. Antimicrobial susceptibility was accomplished using Kirby Bauer disc diffusion technique. Results: Infection rate of wounds in males and females equal 71% (17/250) and 29% (73/250), while infection rate in the age group of 41 to 60 years was the highest with percentage of 49% (122/250). Staphylococcus aureus constituting 76% (181/238) as predominant isolates. SSIs isolates of Staphylococcus aureus were highly resistant to tested antimicrobials. Meropeneme was the drug of choice with sensitivity of 88% and 100% for SSIs and traumatic wounds isolates respectively. Conclusion: In hospitals and community Staphylococcus aureus remain the most common cause of wounds infections. The high resistance to used drugs shown by Staphylococcus aureus in this study requires an assessment of the current situation and finding of more effective anti-staphylococcals.

Pulmonary Tuberculosis among Suspected Sudanese Patients in Wad Madani Tuberculosis Center

Background: Tuberculosis is a health problem in Sudan and may become a greater challenge in the future due to the weakness in infection prevention measures, increase in cases of drug-resistant and the difficulty of diagnosis. Objective: The aim of this study was to detect Mycobacterium tuberculosis (MTB) from sputum of clinically suspected patients using the three available techniques. Methods: Three hundred participants referred to Wad Madani Tuberculosis Center during 2017-2019 were included. Early morning fresh sputum samples were subjected to Mycobacterium tuberculosis examination by Ziehl-Neelsen (ZN) stain without concentration, ZN stain with centrifugation and geneXpert assay. Results: Of the 300 suspected cases; Mycobacterium tuberculosis detected in 17% (51/300) by ZN stain without concentration, 20% (59/300) by ZN stain with centrifugation and 34% (103/300) by geneXpert. The two techniques of ZN stains possessed 100% specificity and relative differences in sensitivity when compared to geneXpert assay. The significant association observed between ZN stains and geneXpert results indicated validity of ZN techniques for detection. Conclusions: The study confirmed that geneXpert is better for identification of Mycobacterium tuberculosis when compared to ZN techniques which are also important for diagnosis in poor places and where the geneXpert assay is not available.

Cytological and molecular screening of Chlamydia trachomatis in infertile women attending a maternity teaching hospital in Gezira State, Sudan: a cross-sectional study

Background: Chlamydia trachomatis (CT) is a sexually transmitted pathogen that threatens reproductive health worldwide. This study aims to screen CT urogenital infection using cytology and molecular methods in women suffering infertility. Methods: In total, 415 women suffering infertility, attending Wad Madani Maternity Hospital were included in this study and then classified into two groups: primary infertile women and secondary infertile women. Both urine (n= 415) and vaginal swab samples (n= 130) were collected and tested using Giemsa stain and Polymerase Chain Reaction (PCR) for detection of CT. Results: CT was detected in 33.7% (140/415) of urine samples and 73.1% (95/130) of vaginal swab samples using Giemsa stain, compared with 44.6% (185/415) and 84.6% (110/130) using PCR, respectively. In the primary infertile group (n= 265), chlamydia was detected in 35.8% (95/265) of urine and 75% (60/80) of swab samples by Giemsa stain compared with 50.9% (135/265) and 75% (60/80) of the samples by PCR. In the secondary infertile group (n= 150), chlamydia was detected in 30% (45/150) of urine and 70% (35/50) of swab samples by Giemsa stain compared with 33.3% (50/150) and 100% (50/50) of the samples by PCR. The associated risk factors were age, lower abdominal pain, and urethritis (p< 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value of Giemsa stain in detecting chlamydia compared to PCR were 86.4%, 100%, 100%, and 83.6%, respectively. Conclusions: Giemsa stain can be used as a screening test for detection of urogenital chlamydia in urine and vaginal samples in places where PCR is difficult to be performed.

Analytical Study of Factors Affecting Wheat Production in Gezira scheme, Sudan (1991- 2015): دراسة تحليلية للعوامل المؤثرة على إنتاج القمح بمشروع الجزيرة –بالسودان للفترة (1991ـ 2015)

Wheat is one of the most important strategic food security crops grown during the winter season in Gezira scheme. This study aimed to identify and to estimate wheat production in Gezira scheme in Sudan during the period (1991- 2015). This study used secondary data information that consists of time series of wheat production, real costs, temperature, economic liberalization (dummy variable) obtained from Wad Madani Meteorological Station, Ministry of Agriculture and Forestry, and Central Bureau of Statistics. This study used analytical descriptive method. Using the Ordinary Least Squares (OLS) technique to estimate climate and same economic factors that influence wheat production in Gezira Scheme though (E- views software). The findings showed that, rising costs have negative effect on production. This explained the fact that production inputs such as agricultural machines, pesticides were imported from other countries, so it affected directly by exchange rate. Results showed that, there were an inverse and significant relationship between average temperature and wheat production during the period of study. On the other hand, economic liberalization (dummy variable) has positive effect on wheat production, considering increase of agricultural finance from 2% to 50% during nineteenth`s from total finance. The study recommended with efficient production technologies to decrease. the real production costs. To cope with climate change conditions, growing early mature and drought tolerant varieties, are crucially needed. More revision and studies concern with economic liberalization policies to alleviate economic distortions that are associated with these policies would be applied.