History of TB in the Sudan

Introduction: Medical history in Sudan is far from being complete. There are no reliable records. Attempt to write on the projects and development of history of TB in the Sudan is a difficult task.Objective: To study and trace the progress of TB in Sudan during the last century through their historical development.Design: A retrospective study.Methods: Data were collected from the annual reports of the Sudan Medical Services. Libraries and a number of previous studies were consulted.Results: The route of entry of TB in the Sudan is mainly from the North. The South was virgin from TB up to 1930s. Northern Sudanese tribes have a high susceptibility and incidence of TB during 1925-1932 (3.7/1000). The south and the Nuba Mountains were almost free from infection or disease. The infectivity rate was highest in North 4.3% while Khartoum showed 3%. In the South, Rumbek district, no TB cases were reported before the age of puberty up to 1930. Prevalence of tuberculosis in 1959/1960 was 26.0% and the detection rate was only 30%.Conclusion: Northern Sudanese contracted tuberculosis while serving in the Egyptian army and cities. The Southern and Western tribes who were almost free from TB infection became highly susceptible to both infection and disease. The infectivity rate remains static during the last 50 years. Keywords: Sennar, Nuba Mountains, Darfur, Kassala, Mediterranea

LEOPOLDOVI HVATOVI: KOLIKO SU ČESTI U NAŠOJ SVAKODNEVNOJ PRAKSI

Objective. To determine how frequent obstetricians use Leopold’s maneuvers in their practice. Subjects and Methods. A questionnaire with numerical scale was distributed among practicing obstetricians. They examined how ­frequent the symphyseal fundal height (SFH) measurement, Leopold’s maneuvers and ultrasound examination for fetal orientation were performed. Results. A total of 165 obstetricians completed the questionnaire. Only 56 (33.9%) respondents indicated that they use SFH. The first and third Leopold’s maneuver were the most frequent abdominal grips ­performed. Only 36 (21.8%) respondents regularly perform all four maneuvers. Seventy seven (46.7%) respondents use ultrasound to determine fetal orientation. The use of ultrasound was significantly higher (p=0.02) in those practicing for less than 10 years (62.6%) compared to those practicing for 10 years or more (43.3%). Conclusion. Leopold’s maneuvers are still common in daily obstetrics practice. Abdominal palpation remains a common method to estimate the uterine size. The first and third Leopold’s maneuver were the most frequent abdominal grips performed. Ultrasound examination is commonly used to determine fetal orientation.Cilj rada je ustanoviti koliko često opstetričari u svojoj praksi rabe Leopold-Pavlikove hvatove. Materijal i metode. Upitnik s brojčanim podatcima je podijeljen opstetričarima iz prakse. Oni su pokazali koliko često izvode ­mjerenje udaljenosti fundus simfiza, Leoplodove hvatove i pregled ultrazvukom za prosudbu fetalnog položaja i stava. Rezultati. Ukupno je 165 opstetričara ispunilo upitnik. Samo 56 (33,9%) njih mjere udaljenost fundus simfiza. Prvi i treći Leopoldov hvat su najčešće rabljeni hvatovi. Samo 36 (21,8%) ispitanika redovito izvode sva četiri hvata. Sedamdeset ­sedam (47,7%) rabe ultrazvučni pregled da odrede položaj i stav djeteta. Uporaba ultrazvuka je bila signifikantno češća (p=0,02) u onih koji rade manje od 10 godina (62,6%) od onih koji rade dulje od 10 godina (43,3%). Zaključak. Leopoldovi hvatovi su još uvijek uobičajeni u svakodnevnoj opstetričnoj praksi. Palpacija trbuha trudnice je uobičajena metoda za prosudbu veličine maternice. Prvi i treći Leopoldov hvat su najčešće rabljeni hvatovi. Pregled ultrazvukom se obično rabi za prosudbu položaja i stava fetusa

Hypopharyngeal Leishmaniasis: A case Report and Literature Review.

Background: Leishmaniasis is classified into three clinical patterns: visceral, cutaneous and mucocutaneous.The latter are sporadically reported in Sudan and may not accompany the visceral type. Laryngeal symptoms including dysphagia may mimic oesophageal malignancy. Early detection and proper diagnosis are of great help in the cure and prognosis of the disease. Case report: We reported a case of primary isolated (the nasal mucosa was not involved) Hypophangeal Leishmaniasis in an immunocompetent Sudanese patient presenting with dysphonia, odynophagia and progressive dysphagia. Conclusion: Leishmaniasis should be suspected in all patients presenting with laryngeal symptoms in patients coming from endemic areas

The growing demand for education in Saudi Arabia: How effective is borrowing educational models from the west?

The Kingdom of Saudi Arabia (KSA) considers education a top priority, and more emphasis has been placed on this following the 2016 announcement of Saudi Vision 2030. Since then, the country has witnessed several economic and social changes. As a result, the Kingdom has initiated a plan to invest in human capital through education to diversify its economy and increase employment. This includes educational reform with regard to primary and secondary education geared toward preparing students for higher education and the workplace. However, several factors may hinder the successful execution of this plan. This report will provide insights into factors such as cultural dimensions, learning profiles, the English language proficiency gap, and information on borrowing educational models from the West. It will also include some suggestions and recommendations to enhance teacher education programmes so that positive educational reform may be achieved effectively.N/

The Influence of Sowing Date on Growth, Yield and Qualityof Sugar Cane

This study was conducted within the commercial field of New Halfa Sugar Scheme, during the period October 1994 to September 1996 to determine the influence of sowing date on sugar cane growth, yield and quality. Climatic elements including temperature, percent relative humidity (%RH) and total rainfall were obtained from Halfa meteorological substation. Soil moisture and actual evaportranspiration (ET( during the growth period were measured. Penman evaporation (E (was calculated. Gernnination percentage, plant population,  plant height, stalk thickness, number of intenodes per stalk, fresh and dry mutter content, pithyness, flowering percentage, brix ( %), purity (%), pol  (%), recovery and fiber (%) were determined. The results showed that July and October planting dates were of signi- ficantly higher values for the different aspects of thermal time, crop factors, germination (%( tiller-ing, (%), plant height, dry matter production, final yield and sugar quality as compared to the late sowing date in March. Pithyness was associated with March planting and decreased with July planting Flowering occurred only in the crop planted in March. The water requirements of the crop differed from the existing indenting system where about 18.6 m3 /feddn(f)/day were required during initial stage, 24.3 m3/ f/day were required during the development stage, 41.28 /m3/f/day were required during the mid season stage and 25.8 m3/f/day were required during the late season stage whereas 31,6 m3/f/day were required as an average for the whole cycle of cane plant. Sugar cane crop required about 314, 1274, 3092 and 4204 accumulated degree days for initiation, development, mid season and maturity, respectively, for optimal productivity. The late planting date in March exposed the crop to harmful effects of heat stress resulting in poor germination and low yield

Evaluation of Guiera senegalenses on Prevention of Type 2 Diabetes Among Sudanese Adult Patients

Guiera senegalensis (GS) reflects the reduced glucose exposure of erythrocytes over a preceding time frame proportional to erythrocyte survival. GS is thus an anti-diabetic function of the glucose-time curve, an educationally useful concept to aid teaching and clinical judgment. Sixty-one newly diagnosed patients with an average age of 48.2 years and a weight of 64.9 kg have participated in the study. Participants were significantly different in their educational, socioeconomic levels, and most of them have no family history of diabetes. To evaluate the hypoglycemic effect of GS, the patients were divided into four groups (G1, G2, G3, and G4) and treated with four different doses of the aqueous extract of the herb ( 0.5, 1, 1.5 and 2 Oz of GS boiled for 10 minutes in 0.5-liter water). The experiment has lasted for five days for each group, and the blood glucose level of the patients was checked using GOD–POD method, at fasting (FBS), and following two hours after the breakfast (RBS). Another group of 30 patients (control) received Douniel drug (5mg/day/person) instead of the GS herb extract and checked for glucose level with the same procedure mentioned above. The results revealed that blood glucose level (mg/dl) for all patients lowered by 9% after every 24 hours of the treatment and by 35% at the end of the treatment. The average fasting and random blood glucose levels were significantly (P<0.001) reduced from 326.21 and 322.95 mg/dl at the start of the treatment to 213.57 and 202.87 mg/dl sequentially at the end of the treatment. The herb significantly (P<0.001) reduced the blood glucose levels, however, with negligible side effects (vomiting on two patients of group G4). Similar hypoglycemic effects on random blood sugar for both the herb extract and Daniel drugs noticed. However, the average fasting blood glucose level of patients treated with herb extract (266.21 mg/dl) was significantly (P<0.001) lower than that of patients treated with the Daniel drug (280.47 mg/dl). Accordingly, the action of this herb may be similar to that of Douniel drug. However, it might have more prolonged action than Douniel. The study strongly recommends GS as a potential herb for the treatment of type II diabetes

Doctor-Patient Communication A Requisite for Better Medication History Taking: Insight from Sudan

Despite the awareness of doctors about the significance of obtaining a comprehensive medication history for patients, they often neglect this in their practice, resulting in an incomplete patient medication list. The study aimed to investigate the role of communication skills as a crucial part of optimal pharmacotherapy. An observational, cross-sectional study was carried out at internal medicine department in a tertiary hospital, Wad Medani, Sudan.&nbsp; The research instrument was a form involved a checklist rating a doctor’s performance during the medical encounters. Among 94 medical doctors, 51% were males and 6.15 (SE) was the average years of experience. About 13% of participants received under-graduation training in communication skills, while 21% had it after post-graduation. Concerning communication skills evaluation, 61% of specialists, 29% of registrars, and 7% of house officers reported an excellent performance. Gender and doctors’ ranking in a medical team had a significant role in communication skills (P-value &lt;0.05) with an overall adjusted R2 of 0.339. Specialists were the most knowledgeable and skillful in obtaining structured medication history; 67% reported an excellent performance. Communication skills had a remarkable impact in getting patient medication history (P-value: &lt;0.05) with an overall adjusted R2 of 0. 763.The study concluded that; gender and doctors’ ranking in the medical team were the main predictors for doctors to be a good communicator. Communication skills have a significant role in medication history taking. There was a gap in knowledge and training in communication skills among internal medicine doctors specifically, “house officers.” This gap negatively contributed to obtaining a comprehensive patient medication history

Utilizing ultrasonic energy for reduction of free fatty acids in crude palm oil

Recently, biodiesel production from abundant bio-sources has drawn the attention of the academic and the industrial community. In this study, crude palm oil (CPO) containing 8.7% free fatty acid content (FFA) was used as raw material. Different common types of acid catalysts (sulfuric acid, methanesulfonic acid and hydrochloric acid) were optimized to investigate the catalytic activity of each acid in the pre-treatment of CPO by the esterification process. Ultrasonic energy was used for the reduction of FFA in CPO. FFA content was measured at different sonication intervals, and the optimum time was determined. Hydrochloric acid showed the highest catalytic activity in the reduction of FFA content in CPO, as well as in converting FFA to fatty acid methyl ester (FAME). From this work, it is reasonable to conclude that there is significant enhancement in the pre-treatment of oils by applying ultrasonic energy using long sonication time.Keywords: Biodiesel, crude palm oil, free fatty acids, ultrasonic energ

The spatial-temporal clustering of Plasmodium falciparum infection over eleven years in Gezira State, The Sudan

<p>Abstract</p> <p>Background</p> <p>Malaria infection and disease exhibit microgeographic heterogeneity which if predictable could have implications for designing small-area intervention. Here, the space-time clustering of <it>Plasmodium falciparum </it>infections using data from repeat cross-sectional surveys in Gezira State, a low transmission area in northern Sudan, is investigated.</p> <p>Methods</p> <p>Data from cross-sectional surveys undertaken in January each year from 1999-2009 in 88 villages in the Gezira state were assembled. During each survey, about a 100 children between the ages two to ten years were sampled to examine the presence of <it>P. falciparum </it>parasites. In 2009, all the villages were mapped using global positioning systems. Cluster level data were analysed for spatial-only and space-time clustering using the Bernoulli model and the significance of clusters were tested using the Kulldorff scan statistic.</p> <p>Results</p> <p>Over the study period, 96,022 malaria slide examinations were undertaken and the <it>P. falciparum </it>prevalence was 8.6% in 1999 and by 2009 this had reduced to 1.6%. The cluster analysis showed the presence of one significant spatial-only cluster in each survey year and one significant space-time cluster over the whole study period. The primary spatial-only clusters in 10/11 years were either contained within or overlapped with the primary space-time cluster.</p> <p>Conclusion</p> <p>The results of the study confirm the generally low malaria transmission in the state of Gezira and the presence of spatial and space-time clusters concentrated around a specific area in the south of the state. Improved surveillance data that allows for the analysis of seasonality, age and other risk factors need to be collected to design effective small area interventions as Gezira state targets malaria elimination.</p