The Prevalence and Management of Metabolic Acidosis of Chronic Kidney Disease

Aim Emerging evidence supports initiating oral sodium bicarbonate (OSB) at a serum bicarbonate (HCO3) level of less than 22mmol/L. We look to identify the prevalence of metabolic acidosis of chronic kidney disease (MA-CKD) and its management with OSB at a regional university hospital. Methods Retrospective data was collected using the national electronic renal database (eMED) to identify chronic kidney disease (CKD) patients with MA-CKD over a one-year period. Results One-hundred and forty-four patients were identified with CKD, of which 131 (89%) were tested for HCO3. MA-CKD was present in 44 patients (34%), all had eGFR< 30ml/min/1.73m2, 7 (16%) were prescribed OSB, 7(16%) OSB was contraindicated, and 37 (84%) patients managed with dietary input only. Mean HCO3 level at initiation in OSB group was 18.3±1mmol/L compared to 19.4±1.4mmol/L in dietary input only group which was statistically significant (p<0.05). Conclusion A high burden of advanced CKD was found in the regional nephrology centre, with one third of patients demonstrating MA-CKD. Majority had dietary input only. Further awareness and consensus need to be established on the benefits of treating MA-CKD with OSB.

Variations of the gallbladder in Sudanese subjects with literature review.

BACKGROUND: Advances in the use of laparoscopic surgery, especially in the biliary apparatus interference makes the need to revise the anatomical data of the gallbladder (GB) more important. Variations of the extra-hepatic biliary apparatus are characterized by large varieties of configurations. OBJECTIVE: The aim of this article was to study the morphology of the GB in Sudanese subjects and review the common variations. MATERIALS AND METHODS: Dissection of formalin-fixed cadavers' abdomens. RESULTS: GB is larger in Sudanese subjects than what is described in the standard text books. CONCLUSION: Congenital anomalies and anatomical variations of the extra-hepatic biliary tree, although not uncommon, can be of clinical importance. There are some differences in the only size of GB in Sudanese.

Physician-Nurse communication. Perceptions of Physicians in Riyadh.

OBJECTIVE: The need for communication between nurse and physician in clinical practice is undisputed. The objectives of this study were to describe doctors' perceptions of their communication with nurses, as related to the openness of the communication and the accuracy of the information communicated and to examine if specific sociodemographic characteristics concerning physicians were associated with perception of communication. METHODS: The sample consisted of 200 physicians selected randomly from 6 randomly selected hospitals representing both general and private. A modified Shortell's Intensive Care Unit physician-nurse communication subscale was used to measure the physician's perceptions of the degree to which openness and accuracy described their communication with nurses. Data was collected via a self-administered pilot questionnaire, which also included sociodemographic characteristics. RESULTS: The overall mean score for openness was 2.61 and 3.19 for accuracy out of a maximum score of 5. For openness the highest mean score was obtained for "listening to physician (4.31)" and the lowest mean score was obtained for "hospital environment (1.84)". For accuracy, the highest mean score was obtained for "use of medical language (4.37)" and the lowest mean score was for "feedback (1.84)". The results showed a significant difference for experience, age and gender for both types of hospitals. For specialization, title and nationality no significant difference was observed for both types of hospitals for openness and accuracy. Multivariate regression analysis showed that gender, age and experience were the predictor variables for openness and accuracy. With more experienced, older aged females, having the highest mean score. CONCLUSION: Communication between physician and nurses needs not remain only a researchable issue; its viability and vitality are crucial to the changing health care scene. Thus, the development of health delivery models that will enable effective multidisciplinary communication, cooperation and wiser use of limited resources in health care is essential.

Action of diclofenac sodium on the reparation process of the surgically-perforated myometrium of pregnant albino rats: morphological and morphometrical evaluation.

1. The action of a non-hormonal anti-inflammatory agent on the reparation process of the surgically-perforated myometrium of pregnant albino rats was histologically evaluated. 2. On the 14th day after perforation, the muscular layers were still interrupted. 3. The morphological study was inconclusive. A morphometrical analysis, however, demonstrated that there was a meaningful diminution in the number of leucocytes and collagen fibers and an increase in the number of fibroblasts, probably with low synthetical power, in the group treated with diclofenac sodium. All these data indicate a delay in the reparation process of the uterine musculature.

First isolation of Trichophyton verrucosum as the aetiology of ringworm in the Sudanese camels (Camelus dromedarius).

A survey was conducted to study camel ringworm in Eastern Sudan. Ringworm was diagnosed in 217 out of 498 young camel calves under two years old examined during a whole year (43.5%). The peak incidence of the disease was found to be in Autumn and Winter. The disease was observed more frequently among young growing calves (1-2 years) than older animals but the prevalence among male and female animals was found to be similar. Lesions were observed mainly on the head, neck and shoulder with frequent extension to the flanks and limbs. Trichophyton verrucosum was isolated in pure culture for the first time from camel ringworm in the Sudan. Histopathological findings of the natural disease are described. Epidemiology in Eastern Sudan is discussed.

An immunoanalysis for kojic acid.

An enzyme-linked immunosorbent assay (ELISA) was developed for the analysis of kojic acid in aqueous solutions and biological fluids. As little as 100 pg kojic acid ml-1 was detected in standard buffer. Analysis of biological fluids containing 1 mg kojic acid ml-1 showed that ELISA could detect the toxin at dilutions of 10(-4) in urine, deporteinated plasma, or serum. Urine and plasma samples collected form rabbits dosed intravenously with 56 mg kojic acid kg-1 body weight gave positive tests at dilutions of 10(-4). The immunoassay described may be used for detection of kojic acid produced during experimental or clinical aspergillosis.