Electrocardiography Interpretation Proficiency Among Medical Doctors of Different Grades in the United Kingdom.

OBJECTIVE: Electrocardiography interpretation is a core clinical skill for all doctors participating in emergency medical services. Given the majority of ECGs initially performed in hospital on admission are reviewed by junior doctors, and the need for life-threatening pathology to be diagnosed or excluded, further understanding of the level of competency in interpretation and factors associated with this are needed. METHODS: This was a cross-sectional, descriptive, analytical study. The data were collected using a structured questionnaire. This was comprised of two sections; the first section contained questions related to confidence, previous ECG learning and factors thought to be associated with ECG interpretation competence. The second section was an ECG quiz of 10 12-lead ECGs of varying complexity for interpretation assessment. Descriptive and inferential statistics were utilized for data analysis. RESULTS: Sixty-two doctors from foundation year 1 to registrar level working in acute medicine across three hospitals participated. The mean overall percentage score for the ECG quiz was 45%. No association was found between junior doctor training grade and overall score on the ECG assessment. Undergraduate and postgraduate teaching strategies also did not impact competence. Only 9.7% reported themselves as "confident" interpreting ECGs. There was a trend towards higher levels of competency among those who felt they had undergone sufficient ECG teaching and those who sought regular feedback from other clinicians. CONCLUSION: This study demonstrated low overall levels of ECG interpretation competency among junior doctors in a large acute teaching NHS trust regardless of grade. Factors associated with competency remain unclear.

Knowledge, attitude and practice towards therapeutic lifestyle changes in the management of hypertension in Khartoum State.

BACKGROUND: Hypertension has long been recognised as a major risk factor for coronary artery disease, stroke and kidney disease. Despite a multitude of new pharmacological agents, in the Sudan, a significant proportion of hypertensive patients' blood pressure remains uncontrolled. An important, often underutilised treatment approach is therapeutic lifestyle changes (TLC). This study aimed to assess the knowledge, attitude and practice of patients with regard to TLC in the management of hypertension in a Khartoum locality in 2016. METHODS: The study was cross sectional and descriptive. Data were collected via structured interviews using a questionnaire. Full coverage of patients attending Ahmed Gasim and Al-Shaab hospitals for follow up during August and September 2016 was carried out. Descriptive and inferential statistics were utilised for data analysis. RESULTS: We identified 112 patients for participation in this study. There was a slight preponderance of females (54.5%) and older age, with 58% in the 55- to 70-year age group. When assessed for knowledge on lifestyle and habits that affect blood pressure, respondents were most familiar with the fact that salt consumption affects blood pressure, 93.8% answering correctly. After knowledge scores were calculated, only 31.3% of participants had above-average knowledge on blood pressure and TLC. The lifestyle change the respondents were least adherent to was regular exercise, with 59.8% of participants struggling with this. Participants' most-cited obstacle was lack of motivation, the same answer being most frequent for each lifestyle change. CONCLUSIONS: This study demonstrated that although the hypertensive patients were generally aware of the importance of TLC in its management, they struggled to implement this. The researcher believes that novel approaches are needed to help motivate patients who are diagnosed with hypertension in a third-world country such as Sudan, and apply their knowledge regarding TLC.

The knowledge attitude and practice (KAP) of mothers of asthmatic children toward asthma in Khartoum asthma clinics.

Prevention of asthma attacks is one of the major challenges of public health. Sufficient knowledge and positive attitudes and correct practices are crucial for the prevention of exacerbations. However, there is insufficiency of information in regard to these in Sudan. The aim of this study was to assess the knowledge and to identify the attitude and practice of mothers of asthmatic children concerning their use of inhalers, compliance to preventers and to measure its effect on the severity of the disease in their children. A sample of 100 consecutive mothers of asthmatic children was enrolled. Any mother with a child diagnosed with bronchial asthma for more than 3 months, and who attended the outpatient clinic of paediatric asthma in Soba or Ahmed Gasim hospitals or the Emergency room of Ahmed Gasim or Ibrahim Malik hospital in the period from 1st to 31st of October 2016 was eligible to be included. Asthma was believed to be infectious by 7% of the respondents. 17% of the mothers thought asthma was preventable by a vaccine. 21% found inhaler use unacceptable. Half of the mothers (50%) did not use the inhaler correctly. Most of the mothers (69%) did not use the inhaler if symptoms were mild and 53% didn't use preventers. The severity of asthma was found to be significantly associated with the attitude and practice of mothers (P < 0.05). In conclusion, sustained efforts are required to increase knowledge about all dimensions of asthma and its management among patients and to disperse myths and misguided judgments regarding the disease and its treatment.