Strategic analysis of the obstetric and gynaecological internship in Sudan

Background: The high expectations of the increasingly questioning society lays a great burden on the first line treating doctors in Sudan. This is particularly true in the obstetrics and gynaecology departments. The impact of training of the house-officer in surgical departments was not studied before in Sudan.The aim: To evaluate the gains in knowledge and skills of house-officers in the obstetrics and gynaecology departments as reflected by their activities and their opinions.Methodology: A prospective cohort carried in the period from May 2011 through June 2011. The data was collected from 200 house-officers. Their activities and duties as formulated by their seniors and supervisors and gains in knowledge and skills were noted.Results: All house-officers participated actively in the clinical diagnosis (history, physical examination and relevant investigations) and management of cases of antepartum and postpartum haemorrhages. Of them 186(93%) had duties not more than twice a week. However, 121(60.5%) shared training opportunities in units having seven or less peers. Also, 109(54.5%) had regular seminars and tutorials. In practice, 165(82.5%) performed evacuations, 158(79%) participated in normal deliveries, and 110(55%) were assisted in performing caesarean sections.Conclusion: The overall performance of house-officers in the department of obstetrics and gynaecology in Sudan is good. However, standards of training need to revisited to fill gabs in training if these young doctors are to be dispatched to rural hospital immediately after the internshipperiod.Key words: Internship, preregistration medical graduates duties, house-officers, obstetrics and gynaecology, medical education, and medical responsibility

Sodium Stibogluconate (SSG) & Paromomycin Combination Compared to SSG for Visceral Leishmaniasis in East Africa: A Randomised Controlled Trial

Visceral leishmaniasis (VL) is a parasitic disease with about 500,000 new cases each year and is fatal if untreated. The current standard therapy involves long courses, has toxicity and there is evidence of increasing resistance. New and better treatment options are urgently needed. Recently, the antibiotic paromomycin (PM) was tested and registered in India to treat this disease, but the same dose of PM monotherapy evaluated and registered in India was not efficacious in Sudan. This article reports the results of a clinical trial to test the effectiveness of injectable PM either alone (in a higher dose) or in combination with sodium stibogluconate (SSG) against the standard SSG monotherapy treatment in four East African countries—Sudan, Kenya, Ethiopia and Uganda. The study showed that the combination of SSG &PM was as efficacious and safe as the standard SSG treatment, with the advantages of being cheaper and requiring only 17 days rather than 30 days of treatment. In March 2010, a WHO Expert Committee recommended the use of the SSG & PM combination as a first line treatment for VL in East Africa

Geographical Variation in the Response of Visceral Leishmaniasis to Paromomycin in East Africa: A Multicentre, Open-Label, Randomized Trial

Visceral leishmaniasis (VL) is a fatal parasitic disease with 500,000 new cases each year according to WHO estimates. New and better treatment options are urgently needed in disease endemic areas due to the long courses, toxicity and development of resistance to current treatments. Recently, the antibiotic paromomycin was tested and registered in India to treat this disease. The current study describes a clinical trial to test the effectiveness of injectable paromomycin, either alone or in combination with the standard drug sodium stibogluconate in three East African countries—Sudan, Kenya and Ethiopia. The study showed that at the same paromomycin dose that was successfully used and registered in India, a far poorer outcome was obtained, particularly in Sudan, suggesting that there are either differences in the patients ability to respond to the drug or in the susceptibility of parasites in East Africa compared with those in India. However, no major safety concerns were noted with the treatment. Further research was initiated to see if a higher dose of paromomycin would perform better, especially in Sudan. The results of this and the performance of the combination arm will be reported later. Our study highlights the importance of considering geographical differences to treatment responses

Strategic analysis of the surgical internship in Sudan

Background: The internship period is internationally recognized the prerequisite official essential training period for the medical graduates to get registered in the local licensing body; in Sudan being the Sudan Medical Council. The evaluation of this important period was not studied before in Sudan.Objectives: To evaluate the performance of house-officers as reflected by their activities and opinions of their supervisors.Methodology: A prospective qualitative study in the period May 2011 through June 2011. The data was collected from 246 house-officers. Their activities, duties as formulated by their seniors and supervisors together with the relevant aspects of the working environment and their aspirationswere noted.Results: A total of 106 (53%) were trained in surgical units having seven or less peers. 118(59%) have worked in surgical units under supervision of surgical registrars and consultants. 157 (78.5%) had duties once or more/week. 129 (64.5%) house-surgeons had regular seminars and tutorials. 163 (81.5%) gained experience in wound suturing. 177 (88.5%) house-surgeons were exposed to clinical diagnoses and management of cases of acute abdomen but, 134 (67%) were able to perform various numbers of appendicectomies. 88(44%) of house-officers had a chance to open or close a vertical midline laparotomy wounds and 140 (70%) had chance to apply a plaster of ParisConclusion: The overall performance of house-surgeons in Sudan as reflected by their activities and opinions is good. However, protocols and guidelines of practice, structure of the training should be made clear before starting the surgical internship

Prevalence of gastrointestinal parasites in young camels in Bahrain

The prevalence of gastrointestinal parasites in young camels in Bahrain is reported for the first time. Six genera of parasites were found. The nematodes observed were Haemonchus contortus (36.47%), Nematodirus spathiger (30.59%) and Trichuris sp. (10.6%); the only cestode recorded was Moniezia expansa (2.4%). The incidence of Eimeria dromedarii was 20%. Single, double, triple and quadruple parasitic infestation occurred in 41.2, 33.5, 19.4 and 5.9% of the infected animals, respectively. Balantidium coli, a protozoan parasite, was occasionally seen in young camels suffering from diarrhea at the time of sampling

Catalysis as a driver for sustainable technologies in Africa – A perspective by the Catalysis Institute at the University of Cape Town

One of the biggest global challenges we are facing today is the provision of affordable, green, and sustainable energy to a growing population. Enshrined in multiple United Nation Sustainable Development Goals – Goal 7: Affordable and Clean Energy; Goal 11: Sustainable Cities and Communities; Goal 12: Responsible Consumption and Production and Goal 13: Climate Action – as well as at the core of the Paris Agreement, it is our task as scientists and engineers to develop innovative technologies that satisfy society's needs while pivoting away from the use of fossil resources. This is a mammoth task with an ambitious timeline. The global development of the industrial sector as we know it is solely based on the exploitation of energy-rich fossil fuels that remain cost-competitive today. However, a gradual change from a market driven to a policy-driven transition allows alternative technologies to make inroads and find applications. One of the most prominently discussed approaches is the Power-to-X (PtX) process envelope. It describes a series of catalytic conversions using only renewable energy, water and captured CO2 to produce green hydrogen, liquid hydrocarbon fuels and chemicals. Especially for sectors that are difficult or impossible to decarbonise, such processes that effectively defossilising the production of energy and goods, represent an important solution.The Catalysis Institute at the University of Cape Town (herein/after referred to as the Catalysis Institute) builds on decades of experience in the individual catalytic processes combined in the PtX concept. In collaboration with our global partners, we are therefore able to develop technologies for the full value chain, considering interdependencies and develop solutions for the African and indeed global society