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Table of Contents
July-September 2016
Volume 11 | Issue 3
Page Nos. 71-100
Online since Wednesday, August 31, 2016
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ORIGINAL ARTICLES
Tuberculosis in Sudan: Efficiency of diagnostic techniques commonly used and investigation of some sociodemographic factors which may influence the disease prevalence
p. 71
Mohammed Sirelkhatim, Ghada Sulieman Sharaf Eldin, Imad Fadl Almula, Ahmed Babiker, Rihab Ali Omer
DOI
:10.4103/1858-5000.189559
Introduction:
Tuberculosis (TB) is a bacterial disease that can be spread through the air. It usually attacks the lungs, but it can also attack and damage the other parts of the body such as the brain, kidneys, or spine. The disease remains to be a major health problem in countries suffering from poverty and unsettlement like Sudan.
Materials and Methods:
In this study, sputum samples were collected from 243 patients (186 males and 57 females) being suspected of pulmonary TB. The patients were distributed in TB specialized clinics in different areas of Central (Khartoum), Eastern (Port Sudan), and Western (Al Obeid) parts of Sudan after they have been informed and agreed to participate in the study. Age, sex, and social status including occupation and housing of the patients were recorded. The patients' common complaints were cough, fatigue, chest pain, shortness of breath, loss of weight, and hemoptysis. Samples were collected, treated with 4% NaOH, and examined both microscopically after having them stained with Ziehl-Neelsen (ZN) stain and microbiologically having them cultured on Lowenstein-Jensen (LJ) media. Isolates were further identified using biochemical tests and resistance to anti-TB drugs was determined. 85.2% (207/243) shown acid-fast bacilli in ZN stain whereas 78.6% (191/243) were positive for mycobacteria in culture. 149 (75%) were successfully subcultured in LJ media and confirmed to be
Mycobacterium tuberculosis
using biochemical tests.
Results:
Of 149 isolated
M.
tuberculosis
species, 18.1% (27), 32.9% (49), 20.7% (31), and 22.4% (33) were resistant to isoniazid, streptomycin, rifampicin, and ethambutol, respectively.
Conclusion:
This study highlights the presence of yet-unknown species of mycobacterium causing active infection with TB in patients in Sudan and the presence of a high percentage of drug resistance which knocks in the alarm of having multidrug-resistant TB circulating in Sudan, a country with many suitable predisposing factors for the disease.
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Driving literacy and distracted driving southern Saudi Arabia experience
p. 79
Ali Al-Bshabshe, Tarique Hussain Ashraf, Mohammed Dwaima, Muhamed Abid, Mueed Al-Harthi
DOI
:10.4103/1858-5000.189560
Background:
Driving is a psychomotor activity that requires a combination of concentration and good visual and auditory functions. It is very important for drivers to be attentive while driving to avoid car accidents. Distracted driving is an act of driving while engaged into other activities such as looking after children, texting, talking on the phone or to a passenger, watching videos, eating, or reading that takes the attention of driver away from the road.
Objective:
To evaluate the driving literacy among students and teachers regarding distracted driving namely the use of mobile phones (texting and talking) while driving and compare them.
Methods:
This is a cross-sectional, questionnaire-based study that contains open-ended, close-ended, and likert scale items. The study took place in Abha City of Aseer Province, KSA from October 1, 2014, to December 31, 2014.
Results:
72% of all respondents were answering the calls while driving. On comparing teachers and students, 77% of students were making calls while driving as compared to 44% of teachers. 56% of the respondents were doing complex tasks like reading a text message while driving. Nearly half of the respondents (48%) did not consider the usage of mobile while driving as dangerous action.
Conclusion:
Proper education regarding distracted driving is the need of hour and it should be started from primary schools. Social media, newspaper, television can be used to increase the awareness. There should be strict laws to ban the use of mobiles and other distracted driving activities while driving.
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Problem-based learning in the National University - Sudan: A reflection on the experience
p. 87
Wisal O.I. Gameel, AO Beeri
DOI
:10.4103/1858-5000.189589
Background:
Since its establishment in 2005, the national university -Sudan (NUSU) has adopted problem- based learning (PBL) as an educational strategy and a teaching method. The increasing number of student's intake every year and the turnover of staff had affected the way PBL sessions were conducted. Therefore, in 2014 a task-force was formed by the faculty of medicine to address the issue.
Objectives:
to investigate the status of PBL in the faculty of medicine and propose required measures.
Methodology:
A task force was formed by the faculty board. It consisted of a medical educationalist, a senior physician, and a physiologist. The group investigated the organization and implementation of PBL. It reviewed the current practice including the timetables, the problem scenarios and the students' attendance records.
Results:
Most of the problem scenarios had no clear source or objectives. The implementation of PBL sessions depended on part-time tutors. There was no structured program for training of tutors. The students 'attendance for PBL sessions was notably poor.
Conclusion:
The task force presented their report including a proposal for actions to be taken. Training workshops for tutors were organized and timetables were restructured to properly accommodate PBL as an active learning method. Implementation of PBL requires continuous support for training of academic staff and provision of learning resources for the students. The use of e-learning should be considered as a future measure to increase the learning opportunities for students and as a solution to the issue of large groups teaching.
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Reference values for hemoglobin A
1c
in males living in Khartoum State: Pilot study 2016
p. 91
Ibrahim Abdelrhim Ali, Hisham Mohammed Abdelrhim, Fatima Ahmed Fadul, Omer Abdelaziz Musa
DOI
:10.4103/1858-5000.189590
Objective:
The objective of this study was to establish the normal values of hemoglobin A
1c
in Sudanese healthy adult males living in Khartoum State and compare the result with the international values.
Materials and Methods:
A cross-sectional study was conducted during 2016 in Khartoum State on adult males of ages between 35 and 45 years and not known to be diabetic or suffering from any chronic illness. Twenty participants were assessed by a questionnaire covering age, family history of diabetes mellitus (DM), physical activity, daily caloric intake and smoking history, and body mass index (BMI) was calculated by measuring weight and height by weight and height measuring devices (scale). A sample of 3 ml venous blood was taken for fasting blood glucose to exclude DM and measurement of HbA
1c
using modified ELISA reader known as Nycocard
©
machine. Correlations between the variables were estimated and
P
< 0.05 was considered statistically significant.
Results:
The mean of HbA
1c
was 3.8% ± 1.17 with a range of 1.2-5.4%. There was no correlation between Hb level, daily caloric intake, and the level of HbA
1c
(
r
= 0). There was intermediate correlation between body mass index and Hb A
1c
- (
r
= 0.32). All the participants in this study had normal body mass index (18.5-25) with mean (23.6). There was weak statistical correlation between age and HbA
1c
(
r
= 0.07), but the family history, smoking, and physical activity were found to be positive statistically significant to HbA
1c
(
P
< 0.05). The mean of HbA
1c
in smokers was 3.8% (±1.4%) and in nonsmokers was 3.1% (±1.0). The mean HbA
1c
of those with positive family history of DM 4% (±0.8%) was significantly higher than those with negative family history 3.5% (±1.3%). The mean of HbA
1c
in physically active participants was 3.9% (±0.9) and in the nonactive participants was 3.1% (±1.3).
Conclusion:
The results of this study indicate that there is a difference in values of HbA
1c
between the international values and Sudan, so the normal values for HbA
1c
in Sudanese need to be established from a large sample.
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REVIEW ARTICLE
A critical review for study proposal for medicine pricing in Sudan
p. 97
Salah Ibrahim Kheder, Hassan Mohamed Ali
DOI
:10.4103/1858-5000.189591
In 2008, the Secretary of National Medicines and Poisons Board (NMPB) carried out a study that measured prices of drugs marketed in Sudan. The unpublished study reported that 23% in public sector and 38% in private sector of studied drugs were higher 10 times than international prices. The importance of the study that it's results in turn were used by Sudanese health policymaker as evidence that policies are needed to contain drug prices. In 2010, the NMPB issued a decree of medicine pricing and according to its regulations registered medicines in Sudan have been revised, and the importers were asked to reduce their prices between 15% and 80% of their registered cost and freight prices. In this review, we criticized and commented only on some conclusions and recommendations without going deeply in the methodological flaws that study suffer from.
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