Assessing Midwives' Knowledge and Practice in Neonatal Resuscitation: Gaps and Transfer of Knowledge to Reduce Mortality.

Introduction: The neonatal period is a crucial time for the survival, growth, and development of newborns. Despite advances in medical science, neonatal mortality rates remain a significant public health issue, and midwives play a critical role in reducing neonatal deaths through the use of evidence-based practices and appropriate neonatal resuscitation techniques. However, studies have shown that healthcare workers, including midwives, may not possess adequate knowledge in neonatal resuscitation, leading to adverse outcomes. This study aims to explore the current state of neonatal care and the role of midwives in neonatal resuscitation, with a focus on training and the transfer of knowledge into practice. It is essential to assess the level of knowledge of midwives in neonatal resuscitation and their ability to transfer this knowledge into action to reduce neonatal mortality rates. Objectives: The objective of this study was to assess the level of knowledge and practice of midwives in neonatal resuscitation, identify gaps in their knowledge and practice, and evaluate their ability to transfer this knowledge into action to reduce neonatal mortality rates. Methods: This study is a cross-sectional, descriptive study conducted in six governmental teaching hospitals located in Khartoum city, with a total sample size of 57 midwives who work in the labor and operation rooms of the hospitals. The questionnaire comprised sections on sociodemographics (5 questions), knowledge assessment (14 questions), and neonatal resuscitation practices (21 questions). The sampling technique used was total coverage. Result: This study included 57 female participants, primarily aged 51-60 years with a one-year diploma level of education. Of those surveyed, 49.1% performed neonatal resuscitation weekly. Participants demonstrated strong knowledge and practice in preparing for birth, but some gaps were identified in equipment usage and identification band placement. Resuscitation skills were generally lacking, with poor performance in ambo bagging and chest compression. Conclusion: This study on Sudanese midwives' neonatal resuscitation knowledge and practices reveals room for improvement in equipment use, identification, and resuscitation skills. Demographic factors affect CPR knowledge and practice.

Singular Value Decomposition-Based Penalized Multinomial Regression for Classifying Imbalanced Medulloblastoma Subgroups Using Methylation Data.

Medulloblastoma (MB) is a molecularly heterogeneous brain malignancy with large differences in clinical presentation. According to genomic studies, there are at least four distinct molecular subgroups of MB: sonic hedgehog (SHH), wingless/INT (WNT), Group 3, and Group 4. The treatment and outcomes depend on appropriate classification. It is difficult for the classification algorithms to identify these subgroups from an imbalanced MB genomic data set, where the distribution of samples among the MB subgroups may not be equal. To overcome this problem, we used singular value decomposition (SVD) and group lasso techniques to find DNA methylation probe features that maximize the separation between the different imbalanced MB subgroups. We used multinomial regression as a classification method to classify the four different molecular subgroups of MB using the reduced DNA methylation data. Coordinate descent is used to solve our loss function associated with the group lasso, which promotes sparsity. By using SVD, we were able to reduce the 321,174 probe features to just 200 features. Less than 40 features were successfully selected after applying the group lasso, which we then used as predictors for our classification models. Our proposed method achieved an average overall accuracy of 99% based on fivefold cross-validation technique. Our approach produces improved classification performance compared with the state-of-the-art methods for classifying MB molecular subgroups.

GC-MS Analysis and Study of the Antimicrobial Activity of Citrus paradisi, Citrus aurantifolia, and Citrus sinensis Peel Essential Oils as Hand Sanitizer.

In the setting of healthcare, the use of hand sanitizers and antiseptics for hand hygiene is of paramount importance to avoid transfer of pathogenic microorganism through hand and skin contact. There is an increasing interest in the incorporation of essential oils in hand sanitizer's formula to avoid the adverse effect of conventional hand sanitizers on health. This study aimed to detect the chemical constituents of citrus peel essential oils and study their antimicrobial activity compared with commercial hand sanitizers. The qualitative and quantitative analysis of the hydrodistillated essential oils of peels of grapefruit (Citrus paradisi), lime (Citrus aurantifolia), and orange (Citrus sinensis) were carried out using gas chromatography mass spectroscopy. The disc diffusion method was used to screen the antibacterial activity of the essential oils against Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, Staphylococcus aureus, and Candida albicans compared with a 78% alcohol-based commercial hand sanitizer. The antimicrobial testing results were statistically analyzed. The highest yield percentage of the obtained essential oils was 1.09% obtained by orange oil. The GC-MS analysis indicated that monoterpene and sesquiterpene hydrocarbons occupied the largest portion of the chemical composition of the three essential oils with D-limonene as the most predominant component. All essential oils showed activity against all tested organisms. Lime essential oil showed comparable antimicrobial activity relative to the commercial 78% alcohol hand sanitizer. In conclusion, essential oils obtained from citrus fruit peel represent a rich source of compounds possessing antimicrobial properties and could be an alternative to synthetic antimicrobial agents.

Epilepsy classification (ILAE Classification 2017) in resource-limited countries: A cross-sectional study on epilepsy in pediatric patients from Sudan

Background: The objective of this study is to utilize the ILAE 2017 to classify epilepsy patients and determine its applicability in Sudan. Methods: This study is a prospective, descriptive, cross-sectional research conducted in two pediatric epilepsy clinics in Khartoum State, Sudan. Results: In this cross-sectional study, 350 pediatric patients with epilepsy were included, with a mean age of 8.4 ± 4.7 years and a mean illness duration of 4.71 ± 3.91 years. The ILAE classification was applied, showing that 71.11% of patients had generalized onset seizures, 27.7% had focal onset seizures, and only 1.1% had unknown onset seizures. Among patients with focal onset seizures, 56.4% had intact awareness, while 43.6% had impaired levels of awareness. The majority of patients who had generalized onset seizures experienced motor onset seizures, with tonicclonic seizures being the most common (44.2%). Nearly all patients with unknown onset seizures experienced tonic-clonic convulsions. These findings provide insights into the prevalence and types of seizures among pediatric epilepsy patients in Sudan and can guide clinicians in developing appropriate treatment plans. Conclusion: This study highlights the importance of utilizing the latest ILAE classification 2017 in epilepsy classification and its potential utilization in resource limited areas like Sudan.

Phenotypic detection of Extended Spectrum ß-Lactamases (ESBL) among gram negative uropathogens reveals highly susceptibility to imipenem.

OBJECTIVE: We aimed to determine antibiotic susceptibility patterns of ESBL- and non-ESBL bacteria isolated from pregnant women with UTI in antenatal wards in Khartoum State, Sudan. METHODS: This cross-sectional study was conducted during April-July 2016 at different hospitals in Khartoum State. Mid-stream urine samples were obtained from 150 hospitalized pregnant women and cultured on CLED (Cystine Lactose Electrolyte Deficient) agar. Microorganisms were identified using standard microbiological procedures. Isolated Gram-negative bacteria were tested for antibiotic susceptibility and ESBL screening using modified Kirby- Bauer method and Double Disc Synergy Test (DDST) respectively. RESULTS: Urine culture revealed positive results in 33/150 (22%) and the most prevalent isolates were Gram negative bacteria (18/33, 54.5%). Among gram-negative bacteria, isolates of E. coli were the most prevalent accounting 66.6% (12/18) followed by K. pneumoniae (4/18, 22.2%) and K. oxytoca (2/18, 11.1%). ESBL was detected in 8/18 (44.4%) of the Gram-negative isolates. Of note, imipenem was the most susceptible antibiotic for ESBL-producer and non-ESBL producer Gram negative isolates, accounting 100% susceptibility for both bacterial groups. Overall susceptibility rates were also high for ciprofloxacin (13/18, 72.2%). In other hand, co-trimoxazole and amoxicillin showed high resistance pattern for ESBL-producer and non-ESBL producer isolates; 27.8%, 44.4% and 38.9%, 38.9% susceptibility rates of co-trimoxazole and amoxicillin for ESBL-producer and non-ESBL producer isolates, respectively. CONCLUSIONS: Imipenem remains the most powerful option for ESBL- and non-ESBL bacteria causing UTIs in pregnant women. However, due to tremendous increase of antibiotic-resistant, antibiotic-susceptibility testing is recommended as a routine investigation for admitted pregnant women.