Saving the Fundaments: Impact of a Military Coup on the Sudan Health System

Military coups are not uncommon occurrences, particularly in developing nations where political systems might be less firmly entrenched or still evolving. Developments of this nature can often have profound implications for the affected nation’s healthcare systems, both in the immediate aftermath and over the longer term. This paper narrates some notable consequences of political instability on the national health system, particularly placing them in the context of the military coup in October 2021 – emphasizing the context behind the political turbulence, its acute and direct consequences, and the possible long-term legacies of political shocks on the already overwhelmed health system. As a descriptive piece, this narrative does not only look at the impact of the military coup on hospitals, but considers the implications for the healthcare system as defined by the WHO, with particular emphasis on the impact of the coup on health funding from multi-laterals, service delivery, human resource availability, and supply chains in Sudan

Saving the fundaments: impact of a military coup on the Sudan health system

Military coups are not uncommon occurrences, particularly in developing nations where political systems might be less firmly entrenched or still evolving. Developments of this nature can often have profound implications for the affected nation’s healthcare systems, both in the immediate aftermath and over the longer term. This paper narrates some notable consequences of political instability on the national health system, particularly placing them in the context of the military coup in October 2021 – emphasizing the context behind the political turbulence, its acute and direct consequences, and the possible long-term legacies of political shocks on the already overwhelmed health system. As a descriptive piece, this narrative does not only look at the impact of the military coup on hospitals, but further considers the different dimensions of the healthcare system as defined by the WHO, therefore reflecting the wider implications on health funding from multi-laterals, service delivery, human resource availability, and medical and vaccine supply chains in Sudan

Prevalence of erectile dysfunction and its associated factors among men in government health clinics In Kuantan, Pahang

INTRODUCTION: Erectile dysfunction (ED) is a significant issue that should not be ignored in the clinical setting and can negatively affect the quality of life of patients and their partners. This study aims to determine the prevalence of ED and its associated factors among men who visited 12 government health clinics in Kuantan, Pahang, Malaysia. MATERIALS AND METHODS: Between July and October 2021, 300 males aged 18 to 60 participated in this cross-sectional study at 12 government health clinics in Kuantan. Information on demographic data, medical history, and lifestyle of the participants was obtained through a self-administered questionnaire that included a validated Malay version of the 21 item Depression Anxiety Stress Scale (DASS 21) and the International Index of Erectile Function (IIEF-5). RESULTS: The overall prevalence of self-reported ED was 69.3%. In terms of severity, 45.7% had mild, 20.7% mild-to-moderate, 2.3% moderate, and 1% severe ED. Multivariate analysis showed that ED associated with diabetes (OR 2.97, 95% CI 1.13–7.79); anxiety (OR 2.85, 95% CI 1.06 – 7.67) and household income (OR 0.41, 95% CI 0.18–0.95). CONCLUSION: ED was high in our study population. Diabetes mellitus, anxiety and household income were significantly associated with ED

Assessment of the Learning styles of MBBS Students at the University of Kassala, Kassala State, Sudan, 2022

Introduction: Since the 1970s, Learning styles of health science students have been researched. It’s important to know the Learning styles of medical students these will be rewarding for both the instructor and the student. Objectives: This study aims to determine the learning styles of the medical students at the University of Kassala. Methodology: Cross sectional descriptive study conducted between 21/3/22 to 23/8/22 at the University of Kassala. After collecting the completed questionnaires, the data was analyzed using R language software Version R i386 4.0.2. Results: Out of 251 study sample, 228 responded with Questionnaire response rate of 90.8%. Wrong filled questionnaires were excluded resulting in 206 usable survey. 66.50485 % of our participants were females, 33.49515 % were males. The average age of the participants in years was 21.71359 +/- 1.933755. Reflectors (61.16505%) were the most prevalent learning style among medical students at the University of Kassala. Differences was noted in learning styles among the different sexes (p-value= 0.0371). No difference between the educational levels concerning the learning style (p-value = 0.09029). The living area does not affect the learning style (P-value = 0.3143). Conclusion and recommendations: Most of our students are reflectors, thus they prefer to watch rather than practice, they might be good at subjects that are more of watching type more than subjects that need practice. The results reveal the need to endorse self-directed learning. Further research is need to identify the most reliable teaching modality and instructional strategies. Keywords: Learning styles, Klob’s Inventory, Medical students DOI: 10.7176/JEP/13-30-01 Publication date:October 31st 202

COVID-19 Vaccine Safety Monitoring Studies in Low- and Middle-Income Countries (LMICs)-A Systematic Review of Study Designs and Methods

BACKGROUND: Post-marketing vaccine safety surveillance aims to monitor and quantify adverse events following immunization in a population, but little is known about their implementation in low- and middle-income countries (LMICs). We aimed to synthesize methodological approaches used to assess adverse events following COVID-19 vaccination in LMICs. METHODS: For this systematic review, we searched articles published from 1 December 2019 to 18 February 2022 in main databases, including MEDLINE and Embase. We included all peer-reviewed observational COVID-19 vaccine safety monitoring studies. We excluded randomized controlled trials and case reports. We extracted data using a standardized extraction form. Two authors assessed study quality using the modified Newcastle-Ottawa Quality Assessment Scale. All findings were summarized narratively using frequency tables and figures. RESULTS: Our search found 4254 studies, of which 58 were eligible for analysis. Many of the studies included in this review were conducted in middle-income countries, with 26 studies (45%) in lower-middle-income and 28 (48%) in upper-middle-income countries. More specifically, 14 studies were conducted in the Middle East region, 16 in South Asia, 8 in Latin America, 8 in Europe and Central Asia, and 4 in Africa. Only 3% scored 7-8 points (good quality) on the Newcastle-Ottawa Scale methodological quality assessment, while 10% got 5-6 points (medium). About 15 studies (25.9%) used a cohort study design and the rest were cross-sectional. In half of them (50%), vaccination data were gathered from the participants' self-reporting methods. Seventeen studies (29.3%) used multivariable binary logistic regression and three (5.2%) used survival analyses. Only 12 studies (20.7%) performed model diagnostics and validity checks (e.g., the goodness of fit, identification of outliers, and co-linearity). CONCLUSIONS: Published studies on COVID-19 vaccine safety surveillance in LMICs are limited in number and the methods used do not often address potential confounders. Active surveillance of vaccines in LMICs are needed to advocate vaccination programs. Implementing training programs in pharmacoepidemiology in LMICs is essential

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

Can WTO membership boost intra-African trade?

This study uses the modified gravity model to examine the determinants of trade in goods within African countries. The panel data covers the period between 2000 and 2019 for all 54 countries in Africa. The article contributes to the existing literature on trade determinants in Africa, including distance and economic size in the study of bilateral trade, by augmenting the gravity model with the inclusion of WTO membership. The gravity model is applied using three different methods of estimation: Ordinary Least Squares (OLS), Poisson Pseudo Maximum Likelihood (PPML), and Gamma Pseudo Maximum Likelihood (GPML) models. Our findings show that the GDP of both exporters and importers, sharing common language and borders positively affect intra-African trade, while the impact of distance is significantly negative. We also found that being a WTO member significantly enhances international trade between African partner countries. This study can help formulate better trade policies for African countries

Prevalence of Erectile Dysfunction and its associated factors among men in government health clinics in Kuantan: Preliminary report

Erectile dysfunction (ED) is a significant issue that should not be overlooked in the clinic. The purpose of this study was to determine the prevalence of ED and its associated factors among men who visited a government health clinic in Kuantan, Pahang, Malaysia. A total of 171 men aged 18-60 years participated in this cross-sectional study. Data of demographic, medical history and lifestyle were gathered through self-administered questionnaire. A validated Malay version International Index of Erectile Function (IIEF-5) was used to assess ED. The overall prevalence of self-reported ED was 71.9%. The prevalence of ED according to severity was as follow mild (43.9%), mild to moderate (25.7%), moderate (1.8%) and severe (0.6%). Multivariate analysis showed that ED associated with unhealthy status (odds ratio [OR 5.490, 95% confidence interval [CI] 2.184-13.795) and age of patient (OR 1.059, 95% CI 1.013 -1.106). ED has significant prevalence among adult male healthcare clinic attendees in Kuantan. Person health status and age were significant associated with ED

Prevalence of erectile dysfunction and its associated factors among men in government health clinics In Kuantan, Pahang.

Introduction: Erectile dysfunction (ED) is a significant issue that should not be ignored in the clinical setting. Underdiagnosis and no proper management can give a negative impact on the quality of life of a patient and their partner. The objective of this study is to determine the prevalence of ED and its associated factors among men who visited a government health clinic in Kuantan, Pahang, Malaysia. Materials and Methods: A total of 300 men aged 18-60 years participated in this cross-sectional study at 12 government health clinics in Kuantan, between 5 July 2021 and 6 October 2021. Information on demographic data, medical history and lifestyle were obtained through self-administered questionnaire included validated Malay version of the 21 item Depression Anxiety Stress Scale (DASS 21) and the International Index of Erectile Function (IIEF-5). Results: The overall prevalence of self-reported ED was 69.7%. In terms of severity, 45.7% had mild, 20.7% mild-to-moderate, 2.3% moderate and 1% severe ED. Multivariate analysis showed that ED associated with increasing age (odd ratio [OR] 6.768, 95% confidence interval [CI] 1.586 – 28.875), unhealthy clinical profile (OR 4.611, 95% CI 2.124 – 10.010), stress (OR 14.630, 95% CI 1.702 – 125.732) and diabetes (OR 2.575, 95% CI 1.055 - 6.284). Conclusion: ED was common among men aged 50 years and above at government health clinics in Kuantan, Pahang. Increasing age, clinical health profile, stress and diabetes were significantly associated with ED