ABSTRACT
Background: The axial length is one of the essential ocular biometric parameters which is to be done prior to any cataract surgery based on ultrasound. These ocular axial length [OAL] values can be influenced by sex, age, race, ethnicity, genetics, and refractive errors
Objectives: The aim of this study is to determine the normal ranges values of OAL in adult Sudanese population and to define the effects of age, gender, and tribal ethnicity on axial length
Materials and Methods: This is descriptive multi-center hospital-based study, carried out over a period of 6 months from January 2015 to June 2015. The study takes place in five study areas: Three in Khartoum and two in Omdorman. These centers are Khartoum Eye Hospital, Makkah Eye Complex, Alwalidain Eye Hospital, and Omdurman Military Hospital and Sudan Eye Center. The study population was recruited from patients presenting to the mentioned five Hospitals Biometric Departments or volunteers who accepted to be enrolled in the study. One thousand Sudanese adults participants [n = 1000], 507 female and 493 male, with ages ranging from 18 to 105 years were included. Patients with vitreoretinal diseases, intraocular surgery, recent trauma and staphyloma were excluded. All participants underwent systematic OAL measurements by A-scan ultrasonography. Effect of age, gender, and tribal ethnicity on OAL was analyzed
Results: The study showed that the average axial length was 23.09 mm ranging from 18.13 mm to 29.09 mm. It was longer in males [average 23.29], ranging from 20.31 mm to 28.48 mm and shorter in females [average 22.81], ranging from 18.31 mm to 29.09 mm. In the four main Sudanese tribes, the Nubian group had the longest axial length [23.23 mm], followed by the African group [23.15 mm], and then the Arab group [23.09 mm]. Bejja group had the shortest axial length [22.85 mm]
Conclusion: OAL in Sudanese adults was within the international standard but with a wider range [18.13-29.09 mm]. Males' OAL was longer than the OAL of females. No significant age OAL variations, but the tribal ethnicity factor was clear, so tribal ethnicity had a major influence on Sudanese OAL
ABSTRACT
Nosocomial infections on neonatal intensive care units [NICUs] have been a recognized cause for concern for many years. Blood stream infections are the most frequent nosocomial infections in NICUs. This work was done to evaluate the impact of infection control practices implementation on intra venous fluid [IVF], medication contamination and neonatal sepsis at NICUs. The study was designed to conduct an infection control practice training course at six private neonatal intensive care units at three governorates with evaluation of the results before and after the study. Samples of all available in-use intravenous fluid bottles and previously used bottles, opened medication ampoules and blood samples from the clinically suspected infants were collected and cultured to detect the organisms and their sensitivity to antimicrobial agents before and one month later after the training course. Also infection control practice observation tool was designed and used for evaluation of the infection control practice at each NICU before the study and one month later. The results showed that K. Pneumonia, K. Terregina and Enterobacter were the commonest types of organisms at the pre-training visit; while at the post-training visit, K. Pneumonia and coagulase negative Staph. were the commonest types of organisms. At the pre-training visit, the IVF contamination rate was 62%, the medication contamination rate was 16.1% and the blood infection rate was 64.8%. At the post training visit, IVF contamination rate dropped to 32%, medication contamination dropped to 0% and the blood infection rate to 50%. There is significant reduction in both IVF and medication contamination frequency [P value = 0.000]. The mean score of infection control practices concerning the training aspects are significantly increased at the post-training visit at the six NICUs. A significant positive correlation was found between infection control practice score in the six NICUs and the negative IV fluid [free samples] [r = 0.5 and P = 0.003]
Conclusions: Surveillance of nosocomial infections in NICUs and successful strategies to decrease infections, such as infection control practice and optimal antibiotic use, are warranted. The significant decrease in contamination rate of IV fluids and medications and positive blood culture results after the training practice point to the importance of microbiological culture of in-use IV fluids which could be a helpful adjunct to epidemiologic studies to directly assess the effectiveness of infection control practices related to IV fluid preparation and use, also point to the significance of proper health hygiene in nosocomial infection control