Tsetse Fly Infection Dynamics and its Implications with Control of Trypanosomiasis in Kajo-Keji County, South Sudan

A two-year study was conducted in Kajo-keji County South Sudan to evaluate tsetse fly infection dynamics which implicate the control of trypanosomiasis in the study area.Infection dynamics ofthe flieswas assessed and monitored using biconical traps.Captured flies were identified, segregated into sexes and age examined using wing fray and ovarian techniques for males and females, respectively. RIME-LAMP test was used to detectTrypanosome species in the midguts of wild tsetse flies.The non-parametric Wilcoxon Signed Rank Test was used to assess the difference in the number of the infected flies between the dry and the wet season counts.The mean infected G.f. fuscipes were: male 6 ±1.4, female 3 ± 1.0 and male 10 ± 2.0, female 3 ± 0.7 in the dry and wet seasons of the year 2011; male,6 ± 1.4,female 6 ±1.4 and male,10 ± 2, female3 ± 0.8 in the dry and wet seasons of 2012.Infection showed significant differences (Z=-2.03,  P = 0.04) with both seasons in 2011 and no significant differences (Z=-1.41, P = 0.16) in 2012. Number of infected male and female flies was positively correlated with the fly age in the dry (Male, R2=0.94; female, R2=0.86) and wet (Male, R2=0.97; female, R2=1) seasons in 2011 and (Male, R2=0.90; female, R2=0.94) in the dry and wet (Male, R2= 0.97 female, R2=1) seasons in 2012.These results showed thatG. f.fuscipeswere  infected with T.brucei gambiense and  they were proved  to be potential vectors for HAT in the study area. Hence, the implications of Tsetse fly infection dynamics in the control of trypanosomiasis need development of further control strategies for sustainable development of livestock and human resources in Kajo-keji County.

Measurement of normal optic nerve for Sudanese pediatric using magnetic resonance imaging

Background: Much congenital and intracranial pathology may affect optic nerve (ON) and caused increased or decreased in size, so the measurement is crucial and aiding in diagnosed of some neurogenic and endocrine disorders. The aim of this study was to measure the normal ON length and diameter by magnetic resonance imaging among pediatric at Khartoum state Sudan.Methods: This was descriptive, cross section study,  done in 100 Sudanese pediatrics with age from 1 month to 15 years came to Magnetic resonance imaging (MRI) department for MRI brain at three hospitals in Khartoum state  (Al-Amal national hospital, Al-Zaitona hospital and Modern Medical Center) during the period from December 2019 to March 2020, all of patients had no pathological or medical condition that may affect the orbits and optic nerve (OON), any child with and medical condition or pathology related to orbits excluded from study sampling. The data were collected by data collection sheet designed especially for this study then analyzed.Results: The study found that the mean diameter of ON was 2.06±0.44 mm, the mean length of right ON was 31.54±4.11 mm, there is no significant different in measurement between males and females (p>0.05), there was strong significant correlation between ON length and diameter with children age (r=0.592**, 0.654**, p<0.001 respectively).Conclusions: The study concluded that there was strong correlation between right and left ON diameter and length with age

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 &lt; 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