Nutritional value and chemical composition of Sudanese millet-based fermented foods as affected by fermentation and method of preparation.

BACKGROUND: Although kissra and hulu-mur are well known millet-based foods in Sudan, the effect of fer- mentation and methods of preparation on their chemical compositions has not been thoroughly investigated. The aim of this study was to investigate the method of preparation and the composition of kisra, and hulu-mur. METHODS: The effect of fermentation and method of preparation on the composition, and mi- crobiological load were examined in millet flour during the preparation of Sudanese fermented foods (kisra & hulu-mur). RESULTS: A significant (P < 0.05) difference in the composition of millet flour and millet-based fermented foods was observed. Protein was significantly increased as a result of fermentation, while oil and carbo- hydrates were decreased. Most minerals increased significantly after the addition of spices to the hulu-mur batter. The total amino acid in millet flour (97.98 g 100 g-1 protein) was influenced by fermentation and preparation method, as it decreased to 86.09 and 88.7 g 100 g-1 protein, in millet batter and kisra, respectively. CONCLUSIONS: Kisra, and hulu-mur were found to have apparent dietary qualities, in spite of some compounds being lost during their production.

Parental knowledge and practices on infant teething, Taif, Saudi Arabia.

BACKGROUND: Parents' false beliefs about signs and symptoms associated with teething have been documented in many studies around the world. This study was conducted to assess parental knowledge on infant teething process and to investigate parents' practices used to alleviate teething disturbances. METHODS: A cross-sectional survey was conducted among parents of children of 6 months-5 years old in Taif, Saudi Arabia during April 2013. Convenience method of sampling was adopted and the data was collected by mean of a structured-questionnaire. Data was processed by SPPS. Logistic regression analysis was performed. P value <0.05 was considered statistically significant. RESULTS: Overall, of 493 participants were included in the final analysis with mean age 35 years. Females constituted more than two-third. All the parents attributed one or more of the listed signs and symptoms to teething process. Desire to bite, fever, gum irritation, increased salivation and diarrhea were the most reported signs and symptoms of teething by 459 (93.1%), 429 (87%), 415 (84.2%), 414 (84%) and 409 (83%) of the parents respectively. The only predictor of ascribing fever as a sign of infant teething was female gender (P = 0.001). However, female gender (P < 0.001), residence (P = 0.039) and educational level (P = 0.006) were found to be significantly associated with ascribing diarrhea as one of the teething symptoms. Only 91 (18.5%) of the parents responded correctly to all questions designed to assess their knowledge on teething process. CONCLUSIONS: Wide gaps in parents' knowledge and practices related infant teething was identified. Educational interventions are needed to upgrade parents' knowledge and improve their practices regarding infant teething process.

Animal health constraints to livestock exports from the Horn of Africa.

The Horn of Africa (Djibouti, Ethiopia, Somalia, Eritrea) is home to the largest population of livestock in Africa and is the historic centre of the livestock trade to the Middle East and northern Africa. The recent resumption of livestock exports from the region has resulted in the handling of over one million head of cattle, sheep, goats and camels at one quarantine facility during a single year. Several of the importing countries for which the facility operates have differing hygiene requirements for the same diseases. Most of the animals handled in the facility come from pastoralist areas, which lack state Veterinary Services. The pathological conditions encountered during one year of monitoring were recorded and the impacts of some of the endemic diseases are discussed, together with particular import-limiting hygiene requirements on this trade.

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.

Knowledge, attitude and practice of health care workers toward Hepatitis B virus infection, Sudan.

OBJECTIVE: This study was set out to assess health care providers' knowledge, attitude and practice towards hepatitis B virus infection (HBV). METHODS: A cross sectional study was carried out, in four public hospitals in Wad Medani, Sudan. Anonymous pre-tested questionnaire was completed by 295 different health care providers. The response rate was 100%. RESULTS: The study revealed that, 97.2% of doctors, 98.6% of nurses, 94.8% of laboratory technicians and 95.7% of other paramedical knew that HBV transmitted via blood. For hygienic precautionary measure; the current study disclosed that (81%) of the responding providers were routinely used to recap needles after use and only (33%) of doctors were always wearing gloves. Gloves were not readily available in all units where there is a high risk of infectious occupational exposure. More than 50% (p < 0.001) of health care workers were not vaccinated against HBV. Healthcare workers had poor knowledge about Universal Standard Precautions Guidelines, and do not fully appreciate their occupational risk regarding hepatitis B infection. Set of recommendations was proposed for formulation and implementation of standard precautions guidelines.

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

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 unfavorable 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

Investigation of medication prescribing errors in Wad Medani, Gezira, Sudan.

This is Sudan's first cross sectional exploratory study aimed to analyze the appropriateness of prescriptions written in different health settings in Wad Medani, Sudan. Two pretested questionnaires were used to collect information about the possible causes of medication errors from randomly selected practicing physicians and pharmacists. The sample consisted of 2000 prescriptions collected in the period of August and September 2009. There were statistically significant differences between legibility of printed and handwritten prescriptions (p < 0.001), of all prescriptions 43.8% was not accompanied by instructions to the patients and 14% contained potential interactions with different degrees of seriousness, ranging from minor 1.8%, moderate 8.4% and severe 3.9%. According to the standard classifications of prescription writing, only one prescription (0.1%) was considered ideal with no error encountered, 12.2% of prescriptions contained errors being potentially serious to the patients, 17.8% showed errors of major importance, 6.9% had errors of minor importance and 10.5% contained trivial errors. While of the prescriptions 52.6% were free from errors but they were incomplete, something that could lead to serious patients' harm. The study identified a range of weaknesses in the prescribing phase and proposed a set of recommendations encouraging physicians and pharmacists to work together to avoid such errors.

Determination of aflatoxin levels in Sudanese edible oils.

Fifty-six samples of groundnut, sesame and cottonseed oils form factories, and traditional mills were collected from several localities in Kordofan, Gezira and Khartoum states, Sudan and assessed for aflatoxin B(1) (AFB(1)), aflatoxin B(2) (AFB(2)), aflatoxin G(1) (AFG(1)) and aflatoxin G(2) (AFG(2)), using high performance liquid chromatography (HPLC). Aflatoxin B(1) (AFB(1)) was detected in eight samples representing 14.3%, the highest incidence of aflatoxin contamination occurred in sesame (7 out of 16 samples, 43.75%) followed by groundnut (1 out of 28 samples, 3.57%) while no aflatoxin contamination was detected in cottonseed oil. Aflatoxin B(1) levels in sesame oil samples ranged from 0.2-0.8 microg/kg and were 0.6 microg/kg in groundnut oil samples. All aflatoxin contaminated samples are unrefined. This paper reports the findings of the first exploratory investigation on presence of aflatoxins in Sudanese edible oils collected from three states.

Availability of Essential Medicines in Sudan?

Introduction: Although availability of essential medicines is one of the most important objectives of national medicines' policies; the unavailability of essential medicines remains a major problem for poor countries. Objective: The study was carried out to measure availability and duration of out of stock of essential medicines in Sudan. Method: The study was carried out using the World Health Organization (WHO) Operational Package for Assessing and Monitoring Pharmaceutical Situation in Countries format for data collection. Results: On the average; availability of selected essential medicines at the public pharmacy; medicine stores and the private pharmacies was found to be 80.6; 90.0and 93.0; respectively. The survey found the mean duration of stock out at medicines store was 26.5 days and no records available about inventory control at the pharmacy level. Among the states; the study found low availability of medicines at North Kordufan public pharmacies. The study found no statistical significant difference as far as a Developing country concerning availability of medicines at rural or urban areas (p 0.05). Conclusion: Generally availability and stock out duration of essential medicines in the Sudan were acceptable

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

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.

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.

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

Acute gluteal abscess following intramuscular chloroquine injection: a clinical and experimental study.

This prospective study contains clinical and experimental parts. In the clinical study, 125 patients given intramuscular chloroquine for malaria were followed for 2 months in order to detect local injection site complications. Adequate local antiseptic conditions were ensured before giving the injection. Twenty-three patients (18.4%) had minimal local reaction in the form of redness, induration and/or a lump. No pyogenic abscess was noted in contrast to a previous report. In the second part of the study, an experimental animal (Green monkey) was given either chloroquine phosphate, Ampiclox or normal saline intramuscularly. The injection site was later biopsied and histologically examined. Intramuscular chloroquine was found to cause severe inflammatory reactions and muscle necrosis, whereas other injections had very minimal local effects. It is concluded that intramuscular chloroquine causes muscle necrosis which may lead to acute pyogenic abscess if minimal contamination takes place.

Leucocyte chemotaxis to mycetoma agents--the effect of the antifungal drugs griseofulvin and ketoconazole.

Polymorphonuclear leucocytes are the predominant cell type in the inflammatory infiltrate around mycetoma grains. Human leucocyte chemotaxis using cells from healthy subjects has been demonstrated using cytoplasmic antigens from 3 mycetoma agents: Madurella mycetomatis and Pseudallescheria boydii, both fungi, and Streptomyces somaliensis, an actinomycete. There was a statistically insignificant increase in chemotaxis in the presence of ketoconazole, but griseofulvin was a potent inhibitor of leucocyte movement. Griseofulvin has been used to improve the clinical appearances in eumycetoma (fungal mycetoma) cases which respond poorly to antifungal chemotherapy and it is suggested that its effect in this condition depends, in part, on its ability to inhibit leucocyte aggregation around mycetoma grains.