Evaluation of Doctors' Knowledge, Attitudes, Behaviors, Awareness and Practices on Rational Antimicrobial Stewardship in a Training and Research Hospital in Mogadishu-Somalia.

Introduction: Historically, antimicrobials have been used to treat microbial illnesses in humans and animals. But throughout this time, antibiotics that had been successful against particular microorganisms started to lose their effectiveness due to rising inappropriate use brought on by ignorance, negligent attitudes, and improper methods. Our goal in conducting this study was to ascertain the knowledge, attitudes, and practices of doctors with relation to the use of antibiotics in light of the growing global and Sub-Saharan African problem of antimicrobial resistance. Methods: In a tertiary hospital in Mogadishu, Somalia, a cross-sectional survey study was carried out to assess experts' and research assistants' knowledge, attitudes, behavior, awareness, and practices regarding the use of antibiotics and antibiotic resistance. A questionnaire consisting of 2 sections and 22 questions was applied to the participants on a voluntary basis. Results: Among the 202 doctors that participated in the study, 49 (24.3%) were specialists, and 153 (75.7%) were assistants. Prescriptions for one to ten antibiotic boxes per week on average were reported by 146 respondents (72.3%). Of the physicians, just 27 (13.4%) did not require assistance when prescribing an antibiotic. The most often accessed sources of support were experts in infectious diseases (43.1%) and national/international antimicrobial guidelines (32.2%). The top three factors contributing to antibiotic resistance in Somalia include misuse of antibiotics (61.4%), unnecessary prescriptions written by doctors (44.6%), and an absence of infectious disease specialists in most institutions (44.1%). Conclusion: As an alarming level of antimicrobial resistance has been observed globally in recent years, the results of our survey will help educate our doctors by gauging their perceptions, attitudes, and knowledge about rational antibiotic use in Sub-Saharan Africa. This will provide better patient outcomes.

Mycetoma case series in Somalia.

Mycetoma is a suppurative chronic bacterial or fungal disease inoculated into the body by minor trauma which may penetrate from subcutaneous tissue to bone. Although the lower extremities are most commonly affected, rare forms can also be seen from time to time. The diagnostic triad of swelling in the affected area, multiple sinus formation, and purulent discharge with grains are typical. Definitive diagnosis is made by isolation of the causative pathogen, radiologic imaging, and histopathologic examination. Antifungal and antibacterial options are applied together with surgery. Our aim in this case series is to report and analyze 10 rare cases of mycetoma.

Lupus Erythematosus Panniculitis: A Rare Case Report.

An uncommon variation of lupus erythematosus is lupus panniculitis. It can exist on its own or in conjunction with discoid or systemic lupus erythematosus. Persistent, sensitive, and hard nodules that are localized on the face, arms, shoulders, breast, and buttocks are its defining features. Scarring, lipoatrophy, and ulceration are occasionally associated with the healing of lesions. We are reporting the first case of lupus erythematosus panniculitis from Somalia. A 60-year-old male patient visited our polyclinic with an upper back nodule and a left upper ulcerated lesion that had been present for four months.

Testicular Tuberculosis: Two Rare Case Report.

Tuberculosis is especially common in African countries where HIV is common. Although pulmonary tuberculosis is generally seen, testicular tuberculosis can rarely be seen in young men. Especially in African countries, it is not possible to study acid-resistant bacilli, polymerase-chain reaction and culture due to financial impossibility. For this reason, history, physical examination, scrotal ultrasonography and fine needle biopsy help in diagnosis in suspected cases of testicular tuberculosis. Cure is possible with six months of treatment.