Knowledge , Attitude and Practice of Dental Health Personnel about dental medical waste at primary health care level – Khartoum state – Sudan

كانت الدراسة وصية مستعرضة على أساس مؤسسي. مجتمع الدراسة: أطباء الأسنان العامون (17) ومساعدو الأسنان (9) استشاري (1). ما مجموعه 27 من العاملين الصحيين مباشرة مع جميع أفراد مجتمع الدراسة. الفئة العمرية الرئيسية هي بين 30-45 سنة كان الهدف العام هو دراسة معرفة وموقف وممارسة العاملين الصحيين في إدارة مخلفات طب الأسنان. النفايات الطبية هي نفايات كلية يتم توليدها من مرافق الرعاية الصحية خلال عملية تقديم الرعاية الصحية وتشمل المحاقن والإبر والأمبولات والضمادات والبلاستيك القابل للتصرف والنفايات الميكروبيولوجية . يتم تصنيف النفايات الناتجة عن مركبات الكربون الهيدروكلورية فلورية على نطاق واسع على أنها نفايات عامة أو خطرة. تؤدي الإدارة الرديئة لنفايات الرعاية الصحية إلى تعريض العاملين في مجال الرعاية الصحية ومعالجي النفايات والمرضى والمجتمع ككل للعدوى والآثار والإصابات السامة ومخاطر تلويث البيئة. من الضروري أن يتم عزل جميع مواد النفايات الطبية عند نقطة التوليد ، ومعالجتها والتخلص منها بطريقة آمنة. أدوات وتقنيات جمع البيانات: إجراء المقابلات باستخدام استبيان: تم ملء استبيان محدد مسبقًا ومختبر من خلال مقابلة أظهرت نتائج الدراسة أن الدراسة تظهر نقصًا في الكوادر الفنية اطباء طب الأسنان ، مستشارون ومساعدو طب أسنان) في جميع المراكز الصحية كما يتضح من طبيب أسنان واحد في معظم المراكز الصحية ومساعدو طبيب أسنان (59٪) لدى بعض المراكز الصحية طبيب أسنان واحد فقط بدون مساعد. أقر ستة وعشرون (96.3٪) من المشاركين بأن النفايات يتم جمعها يوميًا ، وتستخدم غالبية المشاركين 25 (92.6٪) أدوات وملابس واقية على أساس منتظم ، والنفايات الطبية مرتبة من النفايات العادية. فقط 15 (55.6 ٪) من المشاركين يتبعون رمز التلوين لحاويات التخلص منها. كشف تحليل النتائج ما يلي: - تعتبر معالجة النفايات الطبية نشاطًا خطيرًا وتحتاج إلى استخدام معدات الوقاية الشخصية المناسبة ؛ أظهر استخدام أدوات وقائية واقية على أساس منتظم (PPE) درجة ذات دلالة إحصائية بقيمة P (0.01). تعكس النتائج غالبية المشاركين - ثمانية عشر - (72.0 ٪) (بدرجة جيدة. وتعكس وعي الموظفين الكبير بالطبيعة الخطرة للنفايات الطبية وأهمية استخدام معدات الوقاية الشخصية لحماية أنفسهم. جدول (14) . العلاقة بين جمع النفايات الطبية على أساس يومي والممارسة: - العلاقة بين ما إذا كانت النفايات الطبية يتم جمعها على أساس يومي أو لا تعطي درجة جيدة والتي هي ذات دلالة إحصائية. P. القيمة = (0.01) - الجدول (15

Voluntary Local Review Framework to Monitor and Evaluate the Progress towards Achieving Sustainable Development Goals at a City Level: Buraidah City, KSA and SDG11 as A Case Study

Around the world, cities are on the front lines of sustainable development. They are responsible for more than 70% of global carbon emissions. Many of these cities are experiencing dangerous levels of pollution, underemployment, and health disparities. Since 2015, 193 countries have endorsed the 17 Sustainable Development Goals (SDGs), intended to help address a wide range of challenges affecting cities and ultimately secure the resources for their next generations. All states are expected to present the national progress towards the SDGs through a Voluntary National Review (VNR). Despite the importance of the cities within this framework, only a handful of them worldwide have actively begun to review and assess progress towards these SDGs on a city scale. This paper seeks to develop a Voluntary Local Review (VLR) framework to assess and evaluate the progress of cities towards contributing to the SDGs. This framework has been developed by localizing the international and national frameworks to measure the performance of cities as they advance towards achieving the SDGs. Such a framework can serve as a tool for benchmarking progress on different aspects of sustainable development and help urban planners and policymakers prioritize policies and actions to improve urban quality of life. This framework is applied to monitor and evaluate the progress of the city of Buraidah in Saudi Arabia, as it strives towards achieving the targets of SDG11 (“Make cities and human settlements inclusive, safe, resilient and sustainable”).</jats:p

The costs in provision of haemodialysis in a developing country: A multi-centered study

<p>Abstract</p> <p>Background</p> <p>Chronic Kidney Disease is a major public health problem worldwide with enormous cost burdens on health care systems in developing countries. We aimed to provide a detailed analysis of the processes and costs of haemodialysis in Sri Lanka and provide a framework for modeling similar financial audits.</p> <p>Methods</p> <p>This prospective study was conducted at haemodialysis units of three public and two private hospitals in Sri Lanka for two months in June and July 2010. Cost of drugs and consumables for the three public hospitals were obtained from the price list issued by the Medical Supplies Division of the Department of Health Services, while for the two private hospitals they were obtained from financial departments of the respective hospitals. Staff wages were obtained from the hospital chief accountant/chief financial officers. The cost of electricity and water per month was calculated directly with the assistance of expert engineers. An apportion was done from the total hospital costs of administration, cleaning services, security, waste disposal and, laundry and sterilization for each unit.</p> <p>Results</p> <p>The total number of dialysis sessions (hours) at the five hospitals for June and July were 3341 (12959) and 3386 (13301) respectively. Drug and consumables costs accounted for 70.4-84.9% of the total costs, followed by the wages of the nursing staff at each unit (7.8-19.7%). The mean cost of a dialysis session in Sri Lanka was LKR 6,377 (US$56). The annual cost of haemodialysis for a patient with chronic renal failure undergoing 2-3 dialysis session of four hours duration per week was LKR 663,208-994,812 (US$ 5,869-8,804). At one hospital where facilities are available for the re-use of dialyzers (although not done during study period) the cost of consumables would have come down from LKR 5,940,705 to LKR 3,368,785 (43% reduction) if the method was adopted, reducing costs of haemodialysis per hour from LKR 1,327 at present to LKR 892 (33% reduction).</p> <p>Conclusions</p> <p>This multi-centered study demonstrated that the costs of haemodialysis in a developing country remained significantly lower compared to developed countries. However, it still places a significant burden on the health care sector, whilst possibility of further cost reduction exists.</p

A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

BACKGROUND: To identify the best possible outcomes in liver transplantation from donation after circulatory death donors (DCD) and to propose outcome values, which serve as reference for individual liver recipients or patient groups. METHODS: Based on 2219 controlled DCD liver transplantations, collected from 17 centres in North America and Europe, we identified 1012 low-risk, primary, adult liver transplantations with a laboratory MELD of ≤20points, receiving a DCD liver with a total donor warm ischemia time of ≤30minutes and asystolic donor warm ischemia time of ≤15minutes. Clinically relevant outcomes were selected and complications were reported according to the Clavien-Dindo-Grading and the Comprehensive Complication Index (CCI). Corresponding benchmark cut-offs were based on median values of each centre, where the 75(th)-percentile was considered. RESULTS: Benchmark cases represented between 19.7% and 75% of DCD transplantations in participating centers. The one-year retransplant and mortality rate was 5.23% and 9.01%, respectively. Within the first year of follow-up, 51.1% of recipients developed at least one major complication (≥Clavien-Dindo-Grade-III). Benchmark cut-offs were ≤3days and ≤16days for ICU and hospital stay, ≤66% for severe recipient complications (≥Grade-III), ≤16.8% for ischemic cholangiopathy, and ≤38.9CCI points at one-year posttransplant. Comparisons with higher risk groups showed more complications and impaired graft survival, outside the benchmark cut-offs. Organ perfusion techniques reduced the complications to values below benchmark cut-offs, despite higher graft risk. CONCLUSIONS: Despite excellent 1-year survival, morbidity in benchmark cases remains high with more than half of recipients developing severe complications during 1-year follow-up. Benchmark cut-offs targeting morbidity parameters offer a valid tool to assess the protective value of new preservation technologies in higher risk groups, and provide a valid comparator cohort for future clinical trials. LAY SUMMARY: The best possible outcomes after liver transplantation of grafts donated after circulatory death (DCD) were defined using the concept of benchmarking. These were based on 2219 liver transplantations following controlled DCD donation in 17 centres worldwide. The following benchmark cut-offs for the most relevant outcome parameters were developed: ICU and hospital stay: ≤3 and ≤16 days; primary non function: ≤2.5%; renal replacement therapy: ≤9.6%; ischemic cholangiopathy: ≤16.8% and anastomotic strictures ≤28.4%. One-year graft loss and mortality were defined as ≤14.4% and 9.6%, respectively. Donor and recipient combinations with higher risk had significantly worse outcomes. The use of novel organ perfusion technology achieved similar, good results in this high-risk group with prolonged donor warm ischemia time, when compared to the benchmark cohort

Causes of end-stage renal disease in Sudan: A single-center experience

Very limited data are available about the causes of renal diseases leading to chronic renal diseases in all states of Sudan, including Gezira state. Awareness of the cause of end-stage renal disease (ESRD) helps the nephrologists to anticipate problems during renal re-placement therapy and plan preventive measures for the community. Over 1.1 million patients are estimated to have ESRD worldwide, with an addition of 7% annually. This is a cross-sectional study designed to determine the etiology of ESRD among patients with ESRD on regular he-modialysis (HD) at Gezira Hospital for renal disease. This study was conducted in May 2009. The population examined here consisted of 224 patients on regular HD in Gezira Hospital for renal disease. We found that the etiologies were dominated by unknown causes (53.57%). The leading cause of ESRD for those who were younger than 40 years was glomerular disease, hypertension for those between 40 and 60 years and obstruction for those who were older than 60 years

Mortality rate of patients with end stage renal disease on regular hemodialysis: A single center study

End stage renal disease (ESRD) is a devastating medical, social and economic problem in any community and needs dedicated supervision and health care. It is fatal unless treated properly. Despite the improvements in dialysis care, the mortality of patients with ESRD remains high. We retrospectively studied 242 patients with ESRD on regular hemodialysis (HD) at Gezira Hospital for Renal Diseases and Surgery, Sudan, from 1 January to 31 December 2008, to determine the mortality rate and causes of mortality. We found that the mortality rate was 7.44% per year and the leading cause of death was infections (45%) and cardiovascular (22%) diseases

Malaria incidence among kidney-transplanted recipients in an endemic malaria area, Sudan

Malaria is endemic all over Sudan. The population are at risk of malaria infection to variable degrees. Kidney-transplanted patients on maintenance immunosuppressive therapy are known to be prone to infection, but there is not enough data in the medical literature as to whether they are more susceptible to malaria infection in endemic areas. This study was conducted in the Gezira Hospital for Renal Diseases and Surgery to assess the effect of maintenance immunosuppressive therapy in renal transplantation on malaria incidence. A total of 110 individuals were enrolled: 55 were renal-transplanted patients with end-stage renal disease who received kidney transplantation at least one year earlier and were on maintenance immunosuppressive medi-cations. The other 55 individuals were the compatible healthy group. Thorough follow-up was exercised for both groups for one year (January-December 2009). Following the World Health Organization criteria for malaria diagnosis, a total of 51 malarial attacks were reported in both the groups, 25 in the transplanted group and 26 in the controls. The incidence difference between both groups was statistically insignificant [0.76 (΁1.170) and 1.09 (΁1.917) P = 0.282 among transplanted group and control group, respectively]. Providing routine malaria prophylaxis is not required for renal transplant recipients on maintenance immunosuppressive

Spectrum of glomerulonephritis in adult Jordanians at Jordan university hospital

We retrospectively reviewed the records and histopathological findings of 64 ade-quate native kidney biopsies performed at the Jordan University Hospital from January 2002 through December 2006. The nephrotic syndrome (NS) was the main reason for biopsy in 51.6&#x0025; of the cases and deterioration of kidney function in 31&#x0025;. Primary glomerulonephritis (GN) was diagnosed in 59.4&#x0025; of the biopsies, and focal segmental glomeulosclerosis (FSGS) was the most common pathology detected (17.2&#x0025;). Systemic lupus erythematosis was found in 17 patients (26.6&#x0025;), and it was the commonest secondary GN pathology