Post-discharge surveillance of wound infections by telephone calls method in a Sudanese teaching hospital

Surveillance of wound infections has been shown to be a powerful preventive tool, and feedback to the clinical staff reduces wound infection rates. The main objectives of this study were to identify the applicability of telephone calls as a method of post-discharge wound infection surveillance, and to identify patients and procedures characteristics associated with loss for follow-up after hospital discharge. This was a prospective cohort study conducted in Khartoum Teaching Hospital, Sudan. Patients, aged >18 years admitted for elective clean and clean-contaminated surgery during March 1[st] to 31[st] October 2010 were recruited. 1-month surveillance of wound infections was conducted with telephone interviews. Overall 3656 patients were operated on. Of them 1769 [48.4%] were eligible [mean age 37.8+14 years; females, n=1472 [83.3%]]. The performed surgical interventions were 1814. Of these 1277 [70.4%] were clean-contaminated and 537 [29.6%] were clean. Patients who successfully completed the follow-up were 1387 [78.4%], while 368 [20.8%] were lost, and 14 [0.8%] died. The percentage of male patients [85.3%] who successfully completed the follow-up was significantly higher than females [77.8%]; [P=0.002]. Wound infection was detected in 15 [0.8%] cases during hospital stay and 110 [6.2%] others after hospital discharge. The majority of wound infections in the current study appeared in post-discharge period; this emphasis the need for establishment of surveillance program in the hospital. Surveillance of wound infections using telephone calls is applicable in this setting and can be used as an alternative method to clinic-based diagnosis of wound infections

Pharmaceutical representatives' beliefs and practices about their professional practice: a study in Sudan

Pharmaceutical representatives are an important promotional tool for pharmaceutical companies. This cross-sectional, exploratory study aimed to determine pharmaceutical representatives' beliefs and practices about their professional practice in Sudan. A random sample of 160 pharmaceutical representatives were interviewed using a pretested questionnaire. The majority were male [84.4%] and had received training in professional sales skills [86.3%] and about the products being promoted [82.5%]. Only 65.6% agreed that they provided full and balanced information about products. Not providing balanced information was attributed by 23.1% to doctors' lack of time. However, 28.1% confessed they sometimes felt like hiding unfavourable information, 21.9% were sometimes or always inclined to give untrue information to make sales and 66.9% considered free gifts as ethically acceptable. More attention is needed to dissemination of ethical codes of conduct and training about the ethics of drug promotion for pharmaceutical representatives in Sudan

Influence of milk and some Sudanese meals on the dissolution of ciprofloxacin tablets

For a drug to be effective, it must be released from the dosage form, fully dissolved in the gastro-intestinal fluids, be stable as solution in the gastrointestinal fluids, pass through the gastrointestinal barriers into the mesenteric circulation without being metabolized, pass through the liver into the systemic circulation unchanged and reach its site of action. Food is one of the factors which interfere with these processes. The effect of Sudanese meals will be different due to their high contents of fats, proteins and fibers. This study aimed to determine the influence of milk and some Sudanese meals [Foul - Vicia faba -, "Gorrassah with damaa" and "Kissraa with sharmoot"' on the dissolution of ciprofloxacin HCI tablets and hence bioavailability. The influence of milk and the mentioned Sudanese meals on the dissolution of ciprofloxacin was studied using paddle dissolution apparatus. The dissolution of the drug was measured in the presence of each meal individually using U.V.- visible spectrophotometer. The samples were taken with 5 minutes intervals up to 30 minutes. The results obtained were compared to the results of the dissolution of this drug in simulated gastric fluid in fast state [0.1 N HCl]. The study revealed that the dissolution of ciprofloxacin in Sudanese meals is lower than its dissolution in milk- whose reduction of dissolution of ciprofloxacin was mentioned in a lot of studies world-wide. The order of the influence of Sudanese meals, used in the study, was foul followed by kissraa then gorrasah which showed that the influence was directly proportional to the viscosity of the meal. Using two different volumes of foul, the study revealed that influence of meals on the dissolution of ciprofloxacin was significant even small amounts were used

[IL-10 levels determination in Syrian patients with newly diagnosed lymphoma and their relation with disease progression]

Interleukin 10 is an immune regulatory and immunomodulating cytokine, in this study serum IL-10 levels were measured in 44 Syrian patients with newly diagnosed lymphoma [Hodgkin's disease, non Hodgkin's lymphoma] to determine the significance of pre-treatment IL-10 levels. In our attempting to further elucidate the immunological state of lymphoma patients, serum interferon gamma [IFN-GAMMA] [the immune stimulating cytokine] levels were determined. Pre treatment serum IL-10 were measured and patients were followed-up for at least one year, at the end of the study, the significance of basal serum IL-10 levels, and its independence from other prognostic factors were determined. Pre treatment serum IFN-GAMMA were calibrated, and the correlation between IL-10 levels and IFN-GAMMA levels was examined. Serum IL-10 were significantly higher in patients compared with healthy controls [p=0.002], basal IL-10 values were found significantly higher in non responders compared with responders in retrospective analysis [univariate analysis] p=0.008 in both Hodgkin's disease patients [p=0.013], non Hodgkin's lymphoma patients [p=0.004]. Moreover this prognostic value was found to be independent from other prognostic factors, tumour stage [p=0.13], clinical symptoms [p=0.49], [multivariate analysis MANOVA test]. The correlation between IL-10 and IFN-GAMMA in pre treatment lymphoma patients was [r=0.54], and it was stronger in Hodgkin's patients [r=0.93], than non Hodgkin's lymphoma patients group [r=0.53]. the results of the current study show that measurement of pre treatment serum IL-10 levels is of independent prognostic utility in patients with Hodgkin's disease, and some non Hodgkin's lymphoma types

Knowledge of tuberculosis: a survey among tuberculosis patients in Omdurman, Sudan

A cross-sectional study was conducted in different health settings in Greater Omdurman Province with the objective of measuring the patients' knowledge about tuberculosis and its treatment. One thousand tuberculosis patients were randomly selected. Results revealed general unawareness with the disease and its treatment among the interviewees. Only 36.2% of them had satisfactory knowledge about tuberculosis and its treatment. The level of this knowledge was inversely proportional with respondent's age. Males [38.7%] were more knowledgeable than females [31.4%]. The level of satisfactory knowledge increased with increasing educational level. Respondents treated at health facilities implementing the ational Tuberculosis Programme guidelines [34.5%] were more knowledgeable compared to those treated at general hospitals and private clinics where there is no commitment to the uidelines [23.1%]. Increasing coverage of programme implementation to include general hospitals and private sector, the designing of special health educational programmes and interventions directed toward tuberculosis patients to increase their general awareness about the disease and its treatment were recommended

study of incidence of adverse drug reactions among tuberculosis patients, Omdurman, Sudan

A cross sectional study was conducted in Omdurman 'Alkobra' Province with the objective of identifying the occurrence of side effects among tuberculosis [TB] patients, treated with first line anti-TB drugs. Nine hundred forty one patients were selected randomly. Of the interviewees, about 71.2% reported the occurrence of one or more adverse drug effects. The occurrence of dizziness [33.3%], nausea [26.5%], joint pain [23.4%]. burning sensation [15.0%]. and numbness in hands/feet [16.0%] were observed. Certain groups of respondents complained from these effects more than others, e.g. females [78.7%], and alcoholics [75.0%]; [71.8%] of respondents had other disease/s together with TB. and those who used other medication/s with anti-TB drugs [73.7%]. The principal factor responsible for the increased incidence- of these effects seems to be the observed over-doses of anti TB drugs. A set of recommendations was proposed including revision of prescriptions to correct or modify doses, continuous training of health care providers especially in counseling the TB patients about adverse drug reactions, and teaching them to recognize these effects and education of the public to recognize the anti-TB drugs' adverse effects are needed

Impact of the national protocol for malaria treatment on prescribing patterns in Gezira state, Sudan

A cross-sectional study to assess the impact of the national protocol for malaria treatment was conducted in a town in Gezira state, central Sudan, in 2001. Most of the 165 doctors and medical assistants interviewed [80.0%] had not been trained in the protocol and many [57.5%] were still using their own protocols. Analysis of 410 prescriptions showed chloroquine was the most common antimalarial drug used [69.5% of prescriptions]. Compared with a study before implementation of the protocol, more prescriptions met the protocol st and ards for correct chloroquine dose, whereas regimens for administration of intravenous quinine were still inadequate. The study showed a lack of continuous supervision, training and follow-up in the protocol guidelines and negative attitudes of hospital specialists towards the protocol

influence of reconstitution vehicles on the stability of ampicillin oral powders

The effect of different reconstitution vehicles on the stability of ampicillin oral powders was studied. Distilled water, tap water and well water were used for powder reconstitution. The suspensions were stored at 350C that representing the average room temperature in Sudan. The stability of the drug in suspension was tested daily over a period of seven days. The drug contents in the samples were determined using the cup- plate agar diffusion technique and chemical spectrophotometric method. The obtained results, represented the means of 10-20 determinations. The study revealed a higher degradation extent in the ampicillin oral powders reconstituted with water obtained from wells, followed by tap water when compared with the slower rate of degradation in the oral antibiotic that reconstituted with distilled water. In an attempt to decrease the destabilizing effect of the reconstitution vehicles on the daily used oral antibiotic powders, the authors suggested to use such formulae in a single-dose sachet form to be used instantly after reconstitution

In-home drug storage and utilization habits: a Sudanese study

Community drug-use habits were studied in 469 household units in different areas of Sudan. About 97.7% of the investigated families had at least one drug product stored at home. The study revealed a high rate of self-medication [46.9%], repeated use of unfinished stored drugs [55.0%], a high rate of drug exchange among families [59.3%] and poor compliance [71.2%]. In Sudan there is still a great need to educate and to motivate the general public regarding the principles of rational drug use in order to safeguard health and avoid economic losses

Antimalarials prescribing patterns in Gezira state: precepts and practices

A longitudinal pharmacoepidemiological study on prescribing patterns of antimalarials was conducted in Gezira State, Sudan. Different core drug prescribing indicators were identified, measured and correlated. Chloroquine and quinine were the most frequently prescribed antimalaria drugs but in 44.7% of cases, the dosage was inappropriate and did not conform to standard regimens. Due to variable and unmonitored patterns of drug resistance, most medical practitioners in Sudan tend to follow their own protocols to treat severe cases of malaria rather than conforming to standard regimens. We attribute the emergence of a high rate of resistance to malaria chemotherapy to such practices. We recommend interventions to ensure rational prescribing, and call for the formulation of a national antimalarial drugs policy

relation between rumen acidosis and acid base balance in Egyptian buffaloes

Clinical signs of rumen acidosis in 40 buffalos were detected and arranged according to the degree of hyperacidity and the resulting local and absorptive alterations. From physiological and clinical points of view, rumen and blood pH, carbon dioxide tension [P CO2], oxygen tension [PO2], bicarbonate [HCO3], total carbon dioxide [T CO2] and base excess [BE] together with sodium, potassium and chlorides values, were determined in the diseased animals. The obtained results were compared with ten healthy animals. The obtained data revealed lowered values for both rumen and blood pH, bicarbonate, base excess and serum electrolytes with anoxia and hypercapnia in the affected animals