Knowledge and Attitude of Population Towards Iodized Salt in Shendi Locality River Nile State in Sudan

Background: Iodine is observed as one of the most important trace elements in the human body, which is considered very essential during the synthesis of thyroid hormones. Iodine deficiency in humans can cause several diseases or problems, which include spontaneous abortion, increased infant mortality, cretinism, goiter, and mental defects. Methods: The study was conducted as a community based descriptive crosssectional study to determine the knowledge and attitude of the population towards iodized salt in Shendi locality, River Nile State, Sudan, during the period of 2013. In this study, 636 households were included. Questionnaire and observations were used as tools for data collection. The households were selected through a multistage cluster-sampling technique, 636 respondents were selected through systemic random sampling. Results: The study found that the knowledge of the respondents about iodized salt was poor. Out of 636 subjects, 356 (56%) were aware of iodine as a nutritional element. 279 (43.9%) identified that iodine is a chemical element. More than half of the respondents, 355(55.8%), were aware of sources of iodine in foods. The data showed that 299 (47%) of the respondents were aware of the main type of food which contains iodine. 356(56%) were aware of the fact that iodine deficiency had significant influence on the body. In addition, study revealed that 261(41%) of participant were aware of iodized salt. Only 48% of the population knew that iodized salt is necessary to alleviate iodine deficiency disorder. Conclusion: Based on our findings, we conclude that the household has poor knowledge, negative attitude, and poor practice about iodized salt. Hence, health authority should have to develop health education programs to increase the awareness of households about the significance of iodized salt. Also, it involves a proper handling of a continual and effective use of media for broadcasting health education programs

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries