Knowledge of ICU nurses regarding the ongoing nursing assessment of ICU patients in Khartoum city, 2020

Background: An ongoing nursing assessment is the most significant point in the nursing process to be executed in the beginning of every shift which can be accomplished by using different approaches. It needs to be conducted accurately to guide professional nurses’ decision-making ability to further provide holistic nursing care to patients in the intensive care units (ICUs). This study was aimed to assess the ICU nurses’ knowledge regarding ongoing nursing assessment of ICU patients.Methods: This descriptive cross-sectional hospital-based study was conducted in Khartoum city, and included 86 out of the 135 participants working in the critical care units of the main governmental hospitals in Khartoum city. Data were collected using a structured self-administered questionnaire after being tested for validity and then analyzed using mean, standard deviation, and correlation. Data were then presented as frequencies and percentages.Results: The study participants were aged between 20 and 40 years with a female to male ratio of 3:1, and varied levels of experience. Overall, 71.7% of the studied participants scored good on the standardized knowledge classification tool used, with few areas of knowledge gap, impacted by increased experience. Moreover, 36% of the participants used the ABCDE approach for ongoing nursing assessment, followed by the head-to-toe assessment approach (21%).Conclusion: The nurses’ knowledge regarding ongoing nursing assessment was good with a few areas of weakness raising the need for continuous educational and training programs

Knowledge of ICU Nurses Regarding the Ongoing Nursing Assessment of ICU Patients in Khartoum City, 2020

Background: An ongoing nursing assessment is the most significant point in the nursing process to be executed in the beginning of every shift which can be accomplished by using different approaches. It needs to be conducted accurately to guide professional nurses’ decision-making ability to further provide holistic nursing care to patients in the intensive care units (ICUs). This study was aimed to assess the ICU nurses’ knowledge regarding ongoing nursing assessment of ICU patients. Methods: This descriptive cross-sectional hospital-based study was conducted in Khartoum city, and included 86 out of the 135 participants working in the critical care units of the main governmental hospitals in Khartoum city. Data were collected using a structured self-administered questionnaire after being tested for validity and then analyzed using mean, standard deviation, and correlation. Data were then presented as frequencies and percentages. Results: The study participants were aged between 20 and 40 years with a female to male ratio of 3:1, and varied levels of experience. Overall, 71.7% of the studied participants scored good on the standardized knowledge classification tool used, with few areas of knowledge gap, impacted by increased experience. Moreover, 36% of the participants used the ABCDE approach for ongoing nursing assessment, followed by the head-to-toe assessment approach (21%). Conclusion: The nurses’ knowledge regarding ongoing nursing assessment was good with a few areas of weakness raising the need for continuous educational and training programs

IN VITRO ANTIMCROBIAL ACTIVITY OF MANGIFERA INDICA L

The chloroform, methanol and aqueous extracts    of Mangifera indica seeds  were     subjected to preliminary    antimicrobial  activity against   two Gram- positive bacteria   (Bacillus subtilis, Staphylococcus aureus ) three Gram-negative bacteria Escherichia coli, Proteus vulgaris,  Pseudomonas aeruginosa  and two fungi, Aspergillus niger and Candida albicans.The seeds chloroform and methanol extracts showed high activity   against   all organisms tested. The aqueous   extract showed high activity against both Gram-positive    organisms   and    one   Gram-negative bacteria namely Proteus vulgaris, low     activity     against Escherichia coli,  and was   inactive against Pseudomonas aeruginosa.   Therefore the active chloroform and  methanol extracts were further tested against sixty clinical ; Staphyllococcus aureus (n=15 ), Escherichia coli (n=15 ), Proteus vulgaris  (n=15 ) and  Pseudomonas aeruginosa (n=15 ) and the aqueous extract was tested against thirty clinical isolates of Staphyllococcus aureus (n=15 ) and Proteus vulgaris  (n=15 ) collected randomly from  specimens from Sudanese patients.  The clinical isolates exhibited low susceptibility compared to the standard organisms. The standard organisms were tested against reference antibiotics (Ampicillin and Gentamicin). It was found that the chloroform extract of Mangifera indica seeds at 200 mg/ml was more effective than 20mg/ml Ampicillin and15ug/ml Gentamicin against the majority of the organisms tested.The methanol extract   at 200mg/ml was more effective than 40mg/ml Gentamicin against the organisms tested.The aqueous extract was more effective than 40mg/ml Ampicillin against the majority of the organisms tested. All  extracts were inactive against Aspergillus niger.Both chloroform and methanol extracts were active  against Candida albicans while the aqueous extract was inactive. Therefore C.albicans is more susceptible than A.niger.The chloroform extract inhibited C.albicans with inhibitory action between 25-50mg/ml  Nystatin and the methanol extract inhibited C.albicans with inhibitory action almost similar to 10mg /ml Clotrimazole.Therefore the high activity of the plant might justify its uses in traditional medicine

Nonlinear Analysis Of Asymmetric Rc Building Under Repeated Ground Motions

This study deals with the nonlinear response of an asymmetrical reinforced concrete building under single and repeated earthquake ground motions. Two main categories of ground motions, namely near-fault and far-fault, have been taken into consideration in this study. A full scale of a four-storey reinforced concrete building is experimentally tested by European Laboratory for Structural Assessment (ELSA) in Ispra, and the results from experimental test is compared with the numerical results conducted by this study. Then, many ground motions records, recorded in (stiff soil), are assigned to the building followed by the repeated ground motions. The repetition cases are created by considering two cases, the first case considers main-shock and after-shock while the second case considers fore-shock, main-shock and after-shock. The results obtained by far-fault are compared with near-fault results, also the repetition cases are compared with the single ground motion case in terms of top floor displacement, lateral displacement, rotation and interstorey drift ratio. The main finding of this study is from a qualitative point of view the sequence of ground motions lead to higher responds compared with the single case, consequently more damage will occur under repeated cases which should be considered when evaluating structures performance under seismic load

Sensitivity and Specificity of Gold Chromatography Immuno-Assays IgM/IgG Antibody Test for COVID-19: Review of the current literature

Abstract: Background: The World Health Organization recommends molecular tests (PCR) to the diagnosis of COVID-19, which detect the (SARS-CoV2) virus RNA. However, these tests are expensive and give a high negative result. There were urgent medical and public health needs for early diagnosis and treatment to minimize the spread of COVID-19. This review aimed to summarize known to date information about the latest research progress of the sensitivity and specificity of rapid combined IgM/IgG antibody test to diagnose the pandemic novel coronavirus. Methods: The literature search was conducted using PubMed, Google Scholar, Science Direct, supplemented by (Web of Science electronic databases), with the search term (COVID19 or COVID-19, novel coronavirus, SARS CoV-2 or SARS CoV2, Rapid antibody test, IgM/IgG, sensitivity, specificity). Results: The review included eight clinical studies for a total of 782 patients with COVID-19 and 631 healthy control. The sensitivity and specificity of Gold Chromatography Immuno-Assays (GCIAs) IgM/IgG rapid test vary greatly among published studies. The IgM/IgG sensitivity ranged from 73.9 to 89.3% in 6/8 (75%) studies and the IgM/IgG specificity ranged from 88.9 to 100% in the eight (100%) reviewed studies. The pooled data revealed that the average of sensitivity and specificity was 70% and 94.5%, respectively. They agreed on its simplicity, fastness, and fewer requirements. Conclusion: The GCIAs IgM/IgG rapid tests are simply fast and safe. Besides their short turnaround time, no specific equipment or skilled technicians’ requirements, they can serve as a rapid diagnostic test of RT-PCR-negative symptomatic patients and screening of SARS CoV-2 carriers. It cannot take the place of PCR, but the huge lab diagnosis pressure can be greatly relieved and more research is needed to detect its reliability in limited-resource settings.  Keywords: COVID-19, Rapid Test, IgM/IgG, Sensitivity, Specificity, Limited-resource

Patent foramen ovale closure versus medical therapy after cryptogenic stroke: An updated meta-analysis of all randomized clinical trials

Background: Cryptogenic strokes can be attributed to paradoxical emboli through patent foramen ovale (PFO). However, the effectiveness of PFO closure in preventing recurrent stroke is uncertain and the results of previous randomized clinical trials (RCTs) have been inconclusive. Hence, this study pro- vides an updated meta-analysis of all RCTs comparing PFO closure with medical therapy for secondary prevention of cryptogenic stroke. Methods: All RCTs were identified by a comprehensive literature search of PubMed, Embase, the Cochrane Collaboration Central Register of Controlled Trials, Scopus, and Clinicaltrials.gov. The primary outcome was recurrent ischemic stroke and secondary outcomes were transient ischemic at- tack (TIA), all-cause mortality, new-onset atrial fibrillation (AF), serious adverse events, and major bleeding. Results: Five RCTs with 3440 participants were included in the present study (1829 patients under- went PFO closure and 1611 were treated medically). Pooled analysis showed a statistically significant reduction in the rate of recurrent stroke with PFO closure in comparison to medical therapy (OR 0.41; 95% CI 0.19–0.90; p = 0.03). However, there were no statistically significant reductions of recurrent TIAs (OR 0.77; 95% CI 0.51–1.14; p = 0.19) or all-cause mortality (OR 0.76; 95% CI 0.35–1.65; p = 0.48). The risk of developing new-onset AF was increased significantly with PFO closure (OR 4.74; 95% CI 2.33–9.61; p < 0.0001), but no significant differences in terms of serious adverse events or major bleeding between both groups. Conclusions: Patent foramen ovale closure in adults with recent cryptogenic stroke was associated with a lower rate of recurrent strokes in comparison with medical therapy alone.

Optimizing the compliance of pedestrian facilities construction and alteration with accessibility requirements

State and local governments are required by federal and state laws and regulations to provide and maintain accessibility on their sidewalks and pedestrian facilities. Failure of public agencies to comply with these requirements resulted in injuries and subjected several state and local governments to costly non-compliance penalties and legal settlements. To provide better service to people with disabilities and avoid accessibility related penalties, state and local government need to achieve full compliance with accessibility laws and regulations by conducting self-evaluations and developing transition plans. Self-evaluations must be created and frequently updated by state and local governments to assess the compliance of their pedestrian network with accessibility requirements. Transition plans must include a detailed schedule of all upgrade projects that are required to achieve full compliance with accessibility requirements. These self-evaluation and transition plan requirements proved to be a challenging task for state and local governments due to (1) the large size of their pedestrian networks, (2) the limited availability of resources, and (3) lack of specific guidance in accessibility regulations and standards on how to execute these tasks efficiently. Accordingly, decision makers in state and local governments need to improve the efficiency of self-evaluation and optimize the development of transition plans to maximize their compliance with accessibility requirements within their limited budgets and resources. The main goal of this research study is to develop novel models, methodologies, and frameworks for maximizing the compliance of sidewalks and pedestrian facilities with accessibility requirements. To accomplish this goal, the research objectives of this study are to develop: (1) a comprehensive literature review of the latest laws, regulations, standards, guidelines, best practices, court cases, and legal settlements; (2) an effective and concise accessibility field guide; (3) a novel and practical framework for automating the extraction and modeling of sidewalk conditions, dimensions, and geometry from image; (4) a new methodology for assessing the degree of non-compliance of pedestrian facilities with accessibility requirements; and (5) an innovative multi-objective model to optimize the development and execution of transition plan. The performance of the developed models, methodologies, and frameworks was analyzed using real-life case studies. The results of analyzing these case studies illustrated the novel, unique, and practical capabilities of the research outcomes in enabling decision makers to improve the efficiency and effectiveness of their self-evaluations and optimize the development and execution of their transition plans. These capabilities will result in increasing the accessibility of sidewalks and pedestrian facilities for people with disabilities, which will improve their participation in public activities and assist state and local governments in achieving full compliance with accessibility requirements

Integrated framework to mitigate risks in Giad group's strategy implementation

In today's competitive business environment, business entities are faced with greater uncertainties (threats and opportunities) as they strive to create value. In the wake of the current global economic crisis, businesses in a bid to stay competitive have taken several crucial measures. However, for companies to keep track of their strategies, achieve their strategic objectives and reduce the impact of uncertainties, appropriate decisions should be made with a solution that reduces the impact of risks. Technical reports from companies showed that there is deviation from their original strategic plan tracks, and they are unable to achieve their strategic objectives. A preliminary study was conducted to identify the factors that lead to inefficiencies during strategic plan implementation. The result of the preliminary study showed that there is lack of risk management, especially information and incentive alignment risks. This research aims to propose a framework that mitigates risks during strategy implementation, through how the key choices made in strategy will either increase or reduce two characteristic types of risk (information and incentive alignment risks). These two types of risk (which are not mentioned in depth in other or past types of risk management categories) are the key inefficiency creators in the strategic planning and decision making that arise because of decision patterns. The proposed framework considers how to question the key decisions and how to turn inefficiencies into opportunities and points of power to create value. The proposed framework also presents essential fundamental concepts and enablers for achieving sustainable performance such as developing organizational capability, creative thinking, innovation, agility, succeeding through people and sustained outstanding results. The framework presents a mechanism to identify and assess the information and incentive alignment risks in the key decisions. The developed framework helps to reinvent desired strategic performance which lies in changing how decisions are made. The developed framework was validated via Subject Matter Experts (Strategy and risk management experts from GIAD Group Business Units and academic institutions). The feedback from the experts showed that the proposed framework is capable of managing risks during strategy implementation and can be implemented successfully

Expression of E-cadherin, N-cadherin, and Cytokeratin 18 and 19 in Placentas of Women with Severe Preeclampsia

BACKGROUND: Although the exact mechanism leading to preeclampsia is not fully understood, abnormal trophoblast invasion contributes to its pathogenesis. Keratins and cadherin are known to play roles in the regulation of trophoblast proliferation. However, studies describing the association between keratins, cadherin, and preeclampsia are limited. AIM: The current study was conducted to investigate the association of these proteins with severe preeclampsia in Sudanese women. METHODS: A case–control study was conducted at Madani Maternity Hospital, Sudan. The cases included women with severe preeclampsia (n = 56) and healthy pregnant women as controls (n = 56). The assessment of keratin and cadherin was performed using immunohistochemical staining. RESULTS: There was no significant difference between the two groups in their mean age or parity. We found no significant differences in the expression of the markers E-cadherin, N-cadherin, or cytokeratin 18 and 19 in the placentas from individuals with preeclampsia versus controls. The number of placentas with severe preeclampsia versus controls expressing the E-cadherin, N-cadherin, cytokeratin 18, and cytokeratin 19 markers was 46 (82.1%) versus 46 (82.1%) (p = 0.988), 54 (96.4%) versus 48 (85.7%) (p = 0.121), 4 (7.1%) versus 0 (0%) (p = 0.126), and 11 (19.6%) versus 11 (19.6%) (p = 0.532), respectively. There was also no significant difference in the intensity of staining of these four markers (Ecadherin, N-cadherin, and cytokeratin 18 and 19) between severe preeclampsia and control placentas. CONCLUSION: Together, these results indicate that in this setting, the expression of E-cadherin, N-cadherin, CK18, and CK19 is not associated with severe preeclampsia

Effects of sowing method and herbicide application on growth, yield and water productivity of two wheat cultivars

Water management and weed control are crucial components in maximizing wheat yield and water productivity. Little research work has been done on the relationship between sowing methods, chemical weed control and wheat varieties. Field experiments were conducted during 2013/14-2014/15 seasons to evaluate the effect of four sowing methods and herbicide application on the performance of two wheat cultivars at the Gezira and New Halfa Research Stations. The experiment was arranged in a split-split plot design with four replicates, the main plots were assigned to herbicide application (sprayed and unsprayed), sub-plots were allocated to sowing methods (broadcasting + ridging, bed-planting, seed drill and wide level disc), and sub-sub-plots were assigned to wheat cultivars (Bohaine and Imam). Results showed that herbicides did not affect the yield and yield components of wheat for both seasons in the Gezira. Irrespective of herbicide application, seed drill resulted in the highest wheat yield for the two seasons. New Halfa results revealed that the crop growth and yield components were significantly affected. However, the two wheat cultivars resulted in higher yield with bed-planting method under sprayed condition. The interaction of herbicide application and bed-plating methods resulted in higher water productivity, which could be attributed to the lower amount of water applied compared to the other treatments. These results indicated that in the Gezira, unsprayed seed drill and wide level disc sowing methods can be used without yield reduction of wheat. Moreover, herbicides application with bed-planting sowing method in both sites can be used to improve water use efficiency. إدارة مياه الري ومكافحة الحشائش هي أحدى العوامل الأساسية لتعظيم انتاجية القمح وزيادة كفاءة مياه الري. أجريت تجارب حقلية خلال موسمي 2013/14 و 2014/15 لتقييم أثر أربعة طرق للزراعة ومبيد الحشائش على انتاجية صنفين من القمح بمحطتي بحوث الجزيرة وحلفا الجديدة. تم استخدام تصميم القطع المنشقة مرتين بأربع مكررات. وضعت معاملات مبيد الحشائش في الأحواض الرئيسية ووضعت طرق الزراعة في الأحواض الفرعية بينما وضعت الأصناف في الأحواض الفرعية . أوضحت النتائج أن مبيد الحشائش لم يؤثر على الإنتاجية ومكوناتها خلال الموسمين بمحطة بحوث الجزيرة. بغض النظر عن مبيد الحشائش، الزراعة في سطور أعطت أعلى انتاجية خلال الموسمين. كذلك أوضحت النتائج بمحطة بحوث حلفا الجديدة أن النمو ومكونات الانتاجية تأثرتا بصورة معنوية، حيث وجد أن صنفي القمح سجلتا أعلى انتاجية باستخدام الزراعة في مساطب والمكافحة الكيميائية للحشائش. إن أثر تفاعل الزراعة في مساطب والمكافحة الكيميائية للحشائش انتجت أعلى كفاءة مياه ري وذلك يمكن مرده لقلة كمية مياه الري المضافة مقارنةً بالمعاملات الأخرى. النتائج أعلاه تشير إلى أن الزراعة في سطور والزراعة باستخدام الدسك العريض يمكن استخدامهما بالجزيرة لإنتاج القمح دون نقص يذكر في الإنتاجية. اضافةً الي ذلك، فان اضافة مبيد الحشائش لطريقة الزراعة في مساطب يمكن أن تحسن من كفاءة استخدام مياه الري في كلا الموقعين