Adherence of Healthcare Professionals to Evidence-based Clinical Practice Guidelines in the Management of Hemodialysis Patients, Khartoum State, Sudan

Introduction: Hemodialysis (HD) is a complex procedure with many specifications and requires adherence to a set of particular clinical practice guidelines. These guidelines had already been established by globally acclaimed renal authorities and their implementation was shown to correlate with patients’ morbidity and mortality. This study was conducted to evaluate the adherence of healthcare professionals to the evidence-based clinical practice patterns in Khartoum State HD units.Methods: A cross-sectional study was conducted in Khartoum State HD units during the period from September 2010 to January of 2011. Data was collected from the healthcare professionals using a specially designed checklist. The checklist included the evidence-based clinical practice guidelines for the HD vascular access, HD adequacy, anemia of chronic kidney disease (CKD), nutrition, cardiovascular risk assessment, and hepatitis B and C virus infection control. Implementation of these guidelines was evaluated, and further graded using a Likert-type scale.Results: Four randomly selected HD units were included in the study. The rate of implementation of the HD vascular access guidelines was 54.8%, adequacy guidelines 57%, anemia of CKD 68.8%, nutrition 58.4%, cardiovascular risk assessment 57%, and hepatitis B and C infection control guidelines was 79.2%. Overall, the four HD units assessed showed moderate deviations from the practice guidelines of anemia of CKD and hepatitis B and C infection control. Extreme deviations from the clinical practice guidelines were seen in HD vascular access practices, adequacy assessments, nutrition and cardiovascular risk assessment.Conclusion: Hemodialysis services in Khartoum State are in need of great improvements regarding adherence to protocols and the standards of care.Key words: Clinical practice guidelines; Hemodialysis; Suda

Unconventional Reservoir Characterization and Formation Evaluation: A Case Study of a Tight Sandstone Reservoir in West Africa

Unconventional reservoirs, including gas shales and tight gas sands, have gained prominence in the energy sector due to technological advancements and escalating energy demands. The oil industry is eagerly refining techniques to decipher these reservoirs, aiming to reduce data collection costs and uncertainties in reserve estimations. Characteristically, tight reservoirs exhibit low matrix porosity and ultra-low permeability, necessitating artificial stimulation for enhanced production. The efficacy of the stimulation hinges on the organic material distribution, the rock’s mechanical attributes, and the prevailing stress field. Comprehensive petrophysical analysis, integrating standard and specialized logs, core analyses, and dynamic data, is pivotal for a nuanced understanding of these reservoirs. This ensures a reduction in prediction uncertainties, with parameters like shale volume, porosity, and permeability being vital. This article delves into an intricate petrophysical evaluation of the Nene field, a West African unconventional reservoir. It underscores the geological intricacies of the field, the pivotal role of data acquisition, and introduces avant-garde methodologies for depth matching, rock typing, and the estimation of permeability. This research highlights the significance of unconventional reservoir exploration in today’s energy milieu, offering a granular understanding of the Nene field’s geological challenges and proffering a blueprint for analogous future endeavours in unconventional reservoirs

A study of the bubble point test for membrane characterisation

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Investigation of notched composite wood-concrete connections

An initial stage of research on the feasibility of a composite concrete-wood commercial floors system is described. The floors are comprised of concrete placed atop a solid layer of dimension lumber. A notched shear key/anchor detail is used for interlayer connection. This connection detail transfers interlayer force by bearing adjacent materials in the notch. The anchor serves to tighten the layers after curing of the concrete. Initial testing included pull-out tests on the anchor and interlayer slip tests to define the geometry of the connection detail. Test results indicated the structural merit of the connection concept compared to the use of ordinary mechanical connectors

FIELD STUDIES OF STRENGTHENED TIMBER RAILROAD BRIDGE

Comprehensive field testing had been done previously on a typical three-span, open-deck timber deck railroad bridge. The test program was done in cooperation with the Transportation Technology Center, Inc., of the Association of American Railroads. The bridge was subjected to static and moving train loads as well as controlled actuator ramp loading. The bridge was later stiffened by the addition of a stringer to each chord. The bridge was retested after the stiffening using moving train loads. Results of this field study are reported, and comparisons of the response of the bridge before and after the stiffening are made. The efficiency of the stiffening was between 82% and 97%

Histological pattern of primary glomerular diseases among adult Sudanese patients: A single center experience

In Sudan, like most developing countries, the incidence and histologic patterns of primary glomerulonephritis (GN) remains undetermined. A cross-sectional hospital-based prospective study was performed to determine the pattern of primary GN among adult Sudanese patients. The study was conducted at Khartoum Teaching Hospital from September 2010 to August 2011. It included all adult patients with suspected primary glomerular disease and who underwent native kidney biopsy. A total of 83 adult patients were biopsied with 71 patients (85.5%) being diagnosed as having primary GN. Among those with primary GN the mean age was 34.6 ± 18 years and males represent 54.9%. In 46.5% kidney biopsy was indicated by the presence of nephrotic syndrome, whereas in 33.8% biopsies were performed due to unexplained elevations in renal parameters. Primary focal segmental glomerulosclerosis (FSGS) was diagnosed in 29.6% of patients, followed by membrano-proliferative glomerulonephritis (MPGN) in 26.8% and minimal change disease in 16.9%. IgA nephropathy was observed in 5.6%. Complications following kidney biopsies were reported in 9.6% of biopsied patients. Nephrotic syndrome in an adult was the most common indication for kidney biopsy in our unit. A large number of patients were biopsied due to elevated renal parameters, which reflected the increasing awareness toward thoroughly diagnosing patients with suspected reversible kidney damage. In conclusion, FSGS and MPGN make the most common causes of primary GN among Sudanese adults. Creation of a national renal registry is essential for obtaining more specified epidemiological data

Unconventional Reservoir Characterization and Formation Evaluation: A Case Study of a Tight Sandstone Reservoir in West Africa

Unconventional reservoirs, including gas shales and tight gas sands, have gained prominence in the energy sector due to technological advancements and escalating energy demands. The oil industry is eagerly refining techniques to decipher these reservoirs, aiming to reduce data collection costs and uncertainties in reserve estimations. Characteristically, tight reservoirs exhibit low matrix porosity and ultra-low permeability, necessitating artificial stimulation for enhanced production. The efficacy of the stimulation hinges on the organic material distribution, the rock’s mechanical attributes, and the prevailing stress field. Comprehensive petrophysical analysis, integrating standard and specialized logs, core analyses, and dynamic data, is pivotal for a nuanced understanding of these reservoirs. This ensures a reduction in prediction uncertainties, with parameters like shale volume, porosity, and permeability being vital. This article delves into an intricate petrophysical evaluation of the Nene field, a West African unconventional reservoir. It underscores the geological intricacies of the field, the pivotal role of data acquisition, and introduces avant-garde methodologies for depth matching, rock typing, and the estimation of permeability. This research highlights the significance of unconventional reservoir exploration in today’s energy milieu, offering a granular understanding of the Nene field’s geological challenges and proffering a blueprint for analogous future endeavours in unconventional reservoirs