Antimicrobial susceptibility of Escherichia coli isolated from diabetic patients in Mogadishu, Somalia.

Background: Urinary tract infections (UTIs) are a major concern for diabetic patients due to the impact of diabetes on the urinary tract and immune system. Escherichia coli is the most common pathogen causing UTIs in diabetic patients and is known for its resistance. This study aimed to assess the antimicrobial susceptibility of Escherichia coli strains isolated from diabetic patients in Mogadishu, Somalia. Methods: This descriptive cross-sectional study was conducted at Ummah Hospital in Mogadishu, Somalia, from November 2021 to April 2022. Clean catch mid-stream urine specimens were collected from each participant and uropathogens were identified using standard techniques. The samples were cultured on CLED agar and antibiotic susceptibility patterns were determined using the Kirby-Bauer disk diffusion method. Data analysis was performed using SPSS version 20. Results: The overall prevalence of uropathogens among diabetic patients was 236/350 (67.5%) with Escherichia coli being the most common organism. According to multivariate logistic regression, the results showed that Female diabetic patients had a significantly higher likelihood of developing UTIs compared to males (AOR = 2.5, 95% CI: 1.357-4.522, p = 0.003). The duration of diabetes, history of previous UTIs, and previous antibiotic use were also significantly associated with UTIs. All isolates were found to be resistant to Cefotaxime (100%). In addition, high resistance rates were observed with ofloxacin (91%), ciprofloxacin (77.8%), amikacin (60.9%), ceftriaxone (58.3%), and cefepime (51.8%). The most sensitive antibiotics were colistin and imipenem (99.6 and 88.6%, respectively), followed by gentamycin (70%). Conclusion: This study found a high prevalence of uropathogens and increased multi-drug resistance. Continuous surveillance is needed to monitor uropathogen prevalence and resistance rates, guiding treatment recommendations, rational prescription programs, and policy decisions.

Evaluating the Effects of Training to Improve Teaching Skills of Health Sciences Educators in Sudan.

Purpose: This evaluation draws evidence on the outcome of learning and teaching courses that were offered to a number of teaching staff (referred to as trainers) of the Academies of Health Sciences, Midwifery Schools and Centre for Continuous Professional Development in Sudan. Methods: The evaluation was a cross-sectional, institution-based study conducted from October 2017 to January 2018 involving qualitative design. It consisted of direct observations of teaching, focus group discussions with students and semi-structured interviews with managers of teaching institutions. Results: The findings of direct observations revealed that the learning and teaching course has positive effects on the trainers' ability to have clear, well-stated learning objectives; their presentation skills; and their use of different teaching methods. Moreover, the observations showed that trainers who attended the learning and teaching course now encourage the students to ask questions and are providing them with timely feedback about their learning. As students were the main beneficiaries for improved teaching, focus group discussions have shown that students were generally satisfied with trainers' performance regarding the stated learning outcomes, curricula design, use of a range of teaching methods and assessment methods. During in-depth interviews, managers of training institutions expressed satisfaction with the trainers' performance regarding the development of training materials, learners' assessment, supervision, and evaluation of training. Conclusion: Short courses on teaching and learning were a valuable investment for trainers, students, and the overall performance of health sciences training institutions. The evaluation revealed that trainers were able to apply what they have learnt. Moreover, students and managers noticed improvement in the performance of trainers in teaching, course delivery and assessment. It is recommended to expand, cascade and institutionalize the short courses on learning and teaching to all states to improve the capabilities of trainers, which would eventually contribute to the production of competent allied health professions in Sudan.

Seroprevalence of the Serological Markers of Transfusion-Transmissible Infections among Volunteer Blood Donors of Kosti Obstetrics and Gynecology Hospital.

BACKGROUND: Transfusion-transmissible infections are well-known global health challenges. The present study is proposed to investigate the seropositivity of anti-HIV1/2, anti-HCV, HBsAg, and anti-T.pallidum among volunteer blood donors of Kosti Obstetrics and Gynecology Hospital. METHODS: Our study was conducted in a cross-sectional retrospective manner. The data of donors who attended Kosti Obstetrics and Gynecology Hospital throughout 2016 to 2018 were reviewed and retrieved manually from blood bank records. RESULTS: Out of 8139 donors, 22.52% were seropositive for serological markers of TTIs and 1.67% were seropositive for at least two serological markers of TTIs. The overall seropositivity rate of anti-HIV1/2, HBsAg, anti-HCV, and anti-T.pallidum was 1.77%, 6.07%, 1.14%, and 11.87%, respectively (p < 0.000). Anti-T.pallidum was the most frequently detected (p < 0.05) marker across all study variables. TTIs seroprevalence was significantly (p < 0.05) varied according to the age, residence, occupations, and blood groups. Notably, there was a rising trend in the rate of anti-HIV1/2 and seropositivity for more than one marker with age (p < 0.000). Regionally, rural area residents had a higher rate of anti-HIV1/2 (2.20%), HBsAg (6.31%), anti-HCV (1.42%), anti-T.pallidum (18.38%), and multiple markers seropositivity (2.28%) compared to urban areas. Between occupations, the highest rate of anti-HIV1/2 (p = 0.483), HBsAg (p = 0.003), anti-HCV (p = 0.408), anti-T.pallidum (p < 0.000), and multiple markers seropositivity (p < 0.000) were detected in farmers. Regarding the screening, we also found that the frequency of anti-T.pallidum was significantly (p = 0.003) higher in donors who carry the AB+ve blood group, whereas anti-HCV (1.83%) was more frequent in donors carry O-ve blood group (p = 0.255). As seen, anti-T.pallidum+HBsAg was the most frequently (1.22%) co-occurring markers. In contrast, anti-T.pallidum+anti-HIV1/2+HBsAg was the lowest frequency one (p < 0.000). CONCLUSIONS: The study showed an alarming rate of TTIs, which suggests the requirement for comprehensive surveillance and health education programs.

Prospective study of NSAIDs prescribing in Saudi Arabia: Cardiovascular and gastrointestinal risk in patients with diabetes mellitus
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OBJECTIVES: The purpose of this study was to investigate the patterns of nonsteroidal anti-inflammatory drug (NSAID) prescriptions in diabetes mellitus (DM) patients and to evaluate their suitability based on patient gastrointestinal/cardiovascular (GI/CV) risk profiles. MATERIALS AND METHODS: We retrospectively identified patients with DM, who were seen at a primary care facility from March 1 to 31, 2016. GI risk factors, CV histories, and current medications were recorded. Data were evaluated for appropriateness of NSAID prescribing by using current understanding and accepted guidelines. RESULTS: A total of 443 evaluable patients were reviewed. NSAIDs were prescribed in 171 patients (38.5%). Ibuprofen (23.5%) was the most frequently prescribed drug, followed by celecoxib (20%) and naproxen (14.1%). Of 171 patients, 76 (44.4%) had a previous history of CV events, while 52 patients without CV history had a moderate to very high 10-year risk of heart disease. Markedly fewer patients with CV history (19.1%) than patients without CV history were prescribed naproxen. Patients at high GI risk (22.9%) were prescribed traditional NSAIDs without a gastroprotective agent. Overall, 22.9% of patients at high GI risk and 65.8% at high CV risk were prescribed NSAIDs that were not in accordance with current guidelines or recommendations of regulatory agencies. CONCLUSION: Inappropriate prescribing of NSAIDs was found in more than half of the studied DM patients who were at risk for significant GI and CV adverse events. Assessment of GI and CV risks in DM patients is crucial to tailor NSAID selection and optimize patient outcomes.
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Community pharmacist and primary care physician collaboration: The missing connection in pharmaceutical care.

Pharmaceutical care (PC) involves the active participation of the pharmacist in the improvement of the quality of life of the patient through the dispensation, counselling, and monitoring of drug therapy. Community pharmacists often encounter patients first, and, for some patients, the pharmacist is their only contact with a healthcare professional. It is easier and quicker for patients to contact a community pharmacist. However, there is a very limited or a total absence of PC services in community pharmacies of the KSA. To describe the inter-professional collaboration between primary care physicians and community pharmacists concerning PC services, a qualitative study was designed using a thorough, in-depth interview carried out in the cities of Dhahran and Dammam of the Eastern province of the Kingdom.

Grading adenoid utilizing flexible nasopharyngoscopy.

BACKGROUND AND OBJECTIVES: To assess the possibility of adenoid size asymmetry in both nasal sides by nasopharyngoscopy. DESIGN AND SETTINGS: This is a prospective study involving 100 children, with age ranging between 1 and 12 years, performed in Saudi Arabia between January 2010 and December 2011. METHODS: Adenoid was examined and graded I-IV in relation to posterior choana bilaterally by flexible nasopharyngoscopy. The adenoid grade was compared with the other side in each child. RESULTS: The findings from endoscopy were analyzed: there was a high degree of agreement in grading both sides, that was 92% with kappa=0.868. Moreover, there was grade asymmetry in 8% of the cases. CONCLUSION: Adenoid grading using flexible nasopharyngoscopy through one side of the nose may not represent the adenoid grade of the other side in all cases.

Antioxidant activity of different parts from Annona squamosa, and Catunaregam nilotica methanolic extract.

BACKGROUND: We extracted phenolic compounds from Annona squamosa (leaves, bark, roots and seedcake), and Catunaregam nilotica (leaves, bark and seedcake) using methanol and their antioxidant activity was evaluated employing various established in vitro systems. MATERIAL AND METHODS: Annona squamosa (leaves, bark, roots and seedcake), and Catunaregam nilotica (leaves, bark and seedcake) were used in the study. Antioxidant activity was estimated using oxygen radical absorbance capacity, MTT assay and DPPH assays, and polyphenols profile was determined by HPLC method. RESULTS: The total phenolic content was determined by Folin-Ciocalteu method and the highest amounts were 171.5, 170.4, 169.5, and 167.9 g/kg plant extract as GAE for A. squamosa roots, C. nilotica bark, C. nilotica leaves, and A. squamosa bark, respectively. The leaves extracts of the two trees showed high flavoniod content. The results showed that C. nilotica and A. squamosa extracts displayed antioxidant activities, with IC(50) values ranging from 7.81 to 62.5 and from 7.81 to 125.0 µg/ml, respectively using 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay. The different parts extracts from two trees showed good antioxidant activity evaluated by oxygen radical absorbance capacity and MTT assay systems. CONCLUSION: These results suggested that Annona squamosa and Catunaregam nilotica phenolic compounds could be utilized as a natural antioxidant.

Smoking prevention and cessation in the Africa and Middle East region: a consensus draft guideline for healthcare providers--executive summary.

Despite the abundance of scientific evidence confirming the health consequences of smoking and other forms of tobacco use, the tobacco epidemic remains an important public health problem and by 2030 it is predicted that more than 80% of tobacco deaths will be in developing countries. In Africa and the Middle East, many local factors contribute to the initiation and maintenance of tobacco use. Although efforts to reduce the mortality and morbidity associated with smoking and tobacco dependence are underway, there is a need for guidance on how to utilize appropriate tobacco control policies and psychology- and pharmacology-based therapies to counter tobacco dependence as recommended by the Framework Convention on Tobacco Control (FCTC). A group of tobacco cessation experts from public health services and/or academic institutions in Africa and the Middle East participated in a series of four meetings held in Cairo, Cape Town, and Dubai between May 2008 and February 2011 to develop a draft guideline tailored to their region. This article provides the background to the development of this draft smoking cessation guideline and discusses how the recommendations can be implemented and progress monitored to promote both primary prevention and cessation of tobacco use within our countries. The draft guideline for Africa and the Middle East provides an important resource in combating the devastating effects of tobacco use in these regions which can be further localized through engagement with local stakeholders in the countries of the region.

Study of ultrafast dynamics of 2-picoline by time-resolved photoelectron imaging.

The dynamics of electronically excited states in 2-picoline is studied using femtosecond time-resolved photoelectron imaging spectroscopy. The internal conversion from the S(2) state to the vibrationally excited S(1) state is observed in real time. The secondarily populated high vibronic S(1) state deactivates further to the S(0) state. Photoelectron energy and angular distributions reveal the feature of ionization from the singlet 3p Rydberg states. In addition, variation of time-dependent anisotropy parameters indicates the rotational coherence of the molecule.

Self Examination of the breast for early detection of breast cancer The role of medical students in the faculty of medicine University of Gezira -Sudan

"In Sudan, breast cancer is the most common type of cancer accounting for 34.5% of all female cancers. Optimal chances for surviving breast cancer in women is by detecting it early, either by breast self examination (BSE), clinical breast examination by health staff or by mammography. BSE has an important role in the early detection of disease and hence its management as it enables women to detect breast lumps of less than 1.0 cm in diameter."