The Performance of Candidates in the Examinations of the Otorhinolaryngology Specialty, Sudanese National Board of Medical Specializations

Introduction: The Otorhinolaryngology, Head and Neck Surgery Council is one of the first established councils of the Sudanese National Board of Medical Specializations (SNBMS).This report covers the fourth rotation period from 2009-2013. It is meant to be in the form of an analytical study for more objectivity and transparency and to be a model for promotion of the general performance of other councils in administrative, examination and training issues. Objectives: The main objective of this study is to analyze the trainees’ results in part 1 and part 2 (final) examinations with regard to gender and pass rates and to draw relevant indices that help in planning for training and expansion of specialist services. Materials and Methods: This is an analytical retrospective study conducted at the (SNMSB) headquarters Khartoum, Sudan during the period from January 2009- December 2012 .This study covers the fourth rotation of the scientific council for the specialty. The study included all candidates sitting for both part 1 and part 2 examinations (265). Candidates were classified according to gender and pass rates. Candidates who withdrew form the program after passing the part 1 examination were excluded. Results:  The total number of doctors sitting for part 1 examinant was 207. Females were 118 and males were 89. Female to male ratio was 1.3:1.0. Sixty nine (69) doctors passed the examination with over all pass percentage of 33.3%. The percentage of passed candidates among females was 31% and among males was 36%. The total number for trainees sitting for the final examination was 58. Females were 23 and males were 35. Female to male ratio was 1.0: 1.5. Thirty three (33) trainees passed the examination with over all pass percentage of 56.9%. The percentage of passed trainees among females was 52.2% and among males was 60%. The annual number of doctors sitting for part 1 examination showed marked reduction from 69 in the first year to 48 in the fourth year although there was a steady increase in-between. The average annual pass rate for part 1 examination showed noticeable increase from 23% to 42% by the end of the fourth year. The annual number of trainees sitting for the final examination was fluctuating and the biggest number was in the first year. There was a minimal increase in the number of graduates.  Conclusions: Applicants for part one examination are mostly females. Applicants numbers are generally decreasing. The pass percentages are increasing in both parts of the examination. Males performance in both part one and part two examinations is better than females. The number of graduates does not satisfy the national needs for specialist services provision and expansion

Ectopic Thyroid Presenting as a Sublingual Mass in a Sudanese Girl

Although extremely rare, the presence of ectopic thyroid tissue in the sublingual region should be considered in the differential diagnosis of masses in the cervical region. Diagnosis is confirmed by Fine-needle Aspiration\Biopsy Cytology and exclusion of malignancy by histopathologic analysis of the lesion. In general, surgery should not be attemptrd before radioisotope scan is obtained as this might be the only functioning thyroid tissue.  This is a rare case of ectopic thyroid in the sublingual region reported in a Sudanese girl; it was diagnosed after radioisotope thyroid scan and proved to be the only functioning thyroid tissue. &nbsp

Primary Tuberculosis of the Maxillary Sinus: A case report

Tuberculosis is up-to-date a leading cause of human suffering and loss of life. Although tuberculosis is a systemic disease, primary tuberculosis of the paranasal sinuses is rare. It should be kept in mind in any undiagnosed or atypical clinical infection or inflammation in this region. We present here a case of primary paranasal sinuses tuberculosis in an elderly Sudanese woman. Although Sudan is one of the highest three countries in the incidence of tuberculosis, this is the first case to be reported in Suda

Common Ear, Nose & Throat Problems in the Under- Five Sudanese Children

Introduction: The health problems of children and especially the under-5 years are of great concern and impact on both medical and surgical practice. No wonder they attract political and administrative concern Objective: This study aims to identify the common Ear, Nose & Throat (ENT) problems of under-5 Sudanese children and to study the frequency, admissions, available beds and operations and to compare this work load with the rest of the ENT wards. Furthermore, to outline what is needed to improve the services for this age group. Methodology: This is a retrospective hospital–based study including all patients (n=21384) who presented to the ENT department, Wad-Medani Hospital, Gezira, Sudan, during a period of two years from the first of January 2010 to the thirty first of December 2011. Results: The total number of the under-5 children was 2330; which contributed to 41.32% of total paediatric age group, up to 16 years, (n=5639) and 10.90% of the total number of ENT patients who presented to the ENT department at Wad-Medani Hospital. The total number of admissions of under-5 children accounted for 32.72% of all paediatric patients and 20.66% of all ENT patients. Their commonest problems found in this study were; adenoiditis & tonsillitis (37.68%), otitis media (27.25%), Upper respiratory tract infections (URTIs) & allergy (12.31%), foreign body related (12.23%), otitis externa (5.45%), others (3.43%), epistaxis (0.75%), hearing & speech disorders (0.90%). The total number of children under-5 requiring surgical operations constituted 55.46% of all paediatric patients and 33.98% of the total number of all ENT patients who were operated on. Of these operations 57.01% were elective and 42.99% were emergency operations. The main indications in 94.77% of the elective operations were adenoidectomy & tonsillectomy, while most of the surgical emergencies 91.32% were due to foreign body related problems. Conclusions: The ENT problems of the under-5 children in Wad-Medani General Hospital constitute an obvious high proportion of the work load. More attention is to be paid to this age group in terms of facilities, staff training and special requirements needed in settings and equipments. Thus, better handling and outcomes could be achieved for this important and delicate age group

The Impact of the Faculty of Medicine, University of Gezira, Innovative Programme on its Graduates

Introduction: Programme evaluation is the collection and interpretation, through systemic and formal means, of relevant information which serves as a basis for rational judgment in decision situations. This study was conducted as part of the third programme development of the Faculty of Medicine, Gezira University 2010 – 2011. Objectives: The general objective is to study the impact of the Faculty of Medicine, Gezira University, innovative programme, on its graduates. The specific objectives include the evaluation of graduates' competences in the three main areas of domain of learning, i.e. Knowledge, skills and attitude. Materials and Methods: This is a Cross-sectional Study conducted in the period from13th. of January to 12th. of February 2011. The study population includes 146 consultants who have Gezira graduates training with them including house officers, medical officers and registrars. Excluded from the study all consultants who are academic staff members in the FMUG, who are Gezira graduates or who are involved in student training. A questionnaire was designed to answer the questions that address the objectives of the study covered in 32 questions, using a grading scales; 1 to 5: where 1= poor; 2= less than average, 3= average; 4= good; 5= excellent. Results: the response rate for the questionnaire was 73% (146/210), representing 146 consultants working in 23 hospitals in 12 cities. In the overall evaluation of graduates΄ knowledge and cognitive abilities, graduates were rated as good to excellent in (68.3%), average in (25.12%) and poor to below average in only a minority of the graduates. In the overall evaluation of graduates΄ skills and competences, graduates were rated as good to excellent in (72.33%), average in (20.81%) and poor to below average in only a minority of the graduates. In the overall evaluation of attitudes and ethical standards, graduates were rated as good to excellent in the majority (84.06%). In the overall classification, graduates were rated as good to excellent in the vast majority (82.6%), average in the minority (14.5%) and poor to below average in only a few cases. Conclusion The evaluation of graduates' competences is an important element in the educational programme evaluation. These results provide evidence in favour for the innovative educational programme and can encourage other medical schools to adopt it. Further studies are needed to cover other aspects of graduates' evaluations

Anatomical variations of nasal and paranasal sinuses among Sudanese patients undergoing CT scan evaluation at Antalya Diagnostic Center – Khartoum – Sudan, 2017

Introduction: The anatomical variations of the paranasal sinus are common among populations. These variations are asymptomatic most of the time, yet it may be associated with some inflammatory or allergic conditions. Knowledge of these anatomic variations helps in choosing the operative techniques, reducing the surgical complication rates and explains recurrence of disease. Objective: The aim of this study was to investigate the incidence and type of the anatomical variations of the paranasal sinus among adult Sudanese population by using CT scan. Patients and Method: This is a retrospective descriptive and health facility-based study, conducted at Antalya Diagnostic Center, Khartoum, during the period from July to September 2017. Included in the study all patients referred to the center for CT scan of the sinuses (n=151). A simple random technique was used for anatomical variations; with a sample size of 76 patients. Data collection sheet was used included demographic data and the anatomical variations. Data was analyzed using SPSS version 22. Results: The total number of patients diagnosed with variations was 76, which constituted of 50.3% of all patients included in the study. The age of patients ranged between 16 to 65 years, with a mean age of 36.46 (±11.12SD) years. The most frequent age groups were (16 to 25) and (26 to 35) years which constituted (52.63%) of the patients. Males were 34 (44.7%) and females were 42 (55.3%), with a male to female ratio 1:1.23. Relationship between age and gender with anatomical variants was found not statistically significant. Ninety variations were detected among the study sample. Nasal septal deviation was the commonest variation observed in (26.7%), followed by Concha bullosa in (20%), Onodi Cells in (11.1%), Agger nasi in  (10%), frontal sinus hypoplasia in  (10%) and other variations in ( 22.2%) of cases. Most of the variants were unilateral (81.6%) and were more on the left side in (46.1%) of cases. Conclusions and recommendations: the commonest variation was Nasal septal deviation, variations were common among the age group 16 to 35 years with slight female predominance. The study emphasizes the importance of CT scan for the detection of anatomical variations of the paranasal sinus in every patients planned for nasal or sinus surgery

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

Preferred teaching styles of medical faculty:an international multi-center study

BackgroundIn the current wave of educational reforms, understanding teaching styles of medical faculty can help modify instructional strategies for effective teaching. Few studies have probed distinctive teaching styles of medical faculty. We compared preferred teaching styles of faculty from seven medical schools in United Arab Emirates, the Netherlands, Saudi Arabia, Malaysia, Pakistan, and Sudan.MethodsThe validated Grasha-Riechmann teaching style inventory was administered online for data collection and used SPSS version 20.0 for statistical analysis.ResultsOf the 460 invitees, 248 responded (response rate; 54%). Delegator teaching style was most common with a highest median and mean of 2.38 and 2.45, respectively. There was a significant correlation between expert and authority teaching styles, correlation coefficient 0.62. Similarly, we found a significant correlation between authority teaching style and nature of curriculum, correlation coefficient 0.30. Multiple regression analysis showed that only authority teaching style and male gender had significant correlation. Interestingly, 117 (47%) teachers disagreed with the teaching philosophy of delivering course contents by strictly following learning outcomes. Female teachers (114/248) were more willing to negotiate with their students regarding how and what to teach in their course, while male teachers tended to allow more autonomy by allowing students to set their learning agenda.ConclusionsThis study showed that the medical teachers preferred delegator teacher style that promotes students' collaboration and peer-to-peer learning. Most teachers are conscious of their teaching styles to motivate students for scientific curiosity. These findings can help medical educators to modify their teaching styles for effective learning