Background: The irrational use of antibiotics for the treatment of urinary tract infections (UTIs) may lead to increased antimicrobial resistance among uropathogenic Escherichia coli (E. coli), as ...well as multidrug resistance worldwide, which will limit available treatment options for UTIs caused by these organisms. This study aimed to determine the resistance pattern of E. coli causing UTIs in out-patients and in-patients of Soba University Hospital.
Methods: Data were collected from the laboratory records in the Department of Microbiology in Soba Teaching Hospital by using a predesigned checklist and then analyzed using the statistical package for social sciences. Bivariate analysis (Chi-square test) was used to compare between variables.
Results: Out of the 231 E. coli urine cultures, 160 (69.3%) were collected from females. The results showed high resistance to ampicillin (92.4%), amoxicillin-clavulanic acid (83.3%), cephalexin (90.6%), cefuroxime (72%), ceftazidime (71%), ceftriaxone (72%), ciprofloxacin (68%), and co-trimoxazole (75.3%). Collectively, around 188 (81.4%) were multidrug-resistant. On the other hand, the sensitivities of E. coli isolates were 68.8%, 93.1%, 89.4%, and 100% to gentamicin, amikacin, and carbapenems, respectively.
Conclusion: The rate of E. coli resistance was observed to be high to the commonly prescribed drugs for UTIs, including ampicillin, amoxicillin/clavulanic acid, different cephalosporins, fluoroquinolones, and co-trimoxazole. However, E. coli showed lower resistance rates to nitrofurantoin, amikacin, and carbapenems. Thus, these drugs can be reserved for the empirical treatment of UTIs caused by E. coli.
Background:
Adherence to antidiabetic medications is crucial for optimum glycemic control and decreasing complications. This study aimed to assess adherence to antidiabetic medications and the ...associated factors among individuals with type 2 diabetes attending Jabir Abu Eliz Diabetes Centre in Khartoum state, Sudan.
Methods:
This was a descriptive cross-sectional study, recruited 213 individuals with type 2 diabetes, and used a pretested questionnaire. Data were analyzed using the Statistical Package of Social Sciences version 21. Logistic regression analysis was used to check for factors that linked to poor adherence to diabetes medication.
Results:
The median duration of antidiabetic medications use was 8 years; 15.0% were highly adherent to diabetes medications, 44.6% were medium adherent, and 40.4% showed low adherence. Main factors and barriers were medication side effects (18.3%), use of herbal medicine (12.3%), and unavailability of medication (7%). Predictors to nonadherence were gender, and housing status (0.043 and 0.042, respectively).
Conclusion:
Level of adherence to diabetes medication was unsatisfactory as only 15% showed high adherence. Predictors of nonadherence were gender, and housing status. Effective interventions should be implemented to improve medication adherence, like appropriate patient education and involvement in the treatment plan.
Background: Nocturnal enuresis or bedwetting is the most common type of urinary incontinence in children. The wide prevalence of nocturnal enuresis speaks to the need for an improved understanding of ...this condition by others to improve the management plan. The management can be motivationally or pharmacologically. Our study aimed to evaluate the management outcomes of primary mono-symptomatic nocturnal enuresis among Sudanese children. Methods: A retrospective hospital-based survey was carried to assess 52 children aged 5-18 years (21:31 male: female ratio) and suffering from primary mono-symptomatic nocturnal enuresis. They divided into two groups; Group 1 (28 patients) were on desmopressin melt tablet 120 mcg once daily before bedtime, while Group 2 (24 patients) were on simple behavioral therapy. Data were collected by a well-designed checklist and analyzed using SPSS. Results: The wetting frequency decreased at the end of treatment by a total response rate of 96.4% with desmopressin and 75% with simple behavioral therapy. The complete response and partial response rate of desmopressin at the end of treatment were 89.3% and 7.1%, respectively. For simple behavioral therapy, the complete response and partial response rates at the end of treatment were 66.7% and 8.3%, respectively. The number of wet night per week at the end of 2 weeks of treatment among the two groups was statistically significant, with P = 0.025. Moreover, the relapse rate was higher with simple behavioral therapy (66.7%) than with desmopressin (57.1%). Conclusion: There is a highly significant decrease in wet nights in response to both desmopressin and simple behavioral therapy, both interventions were effective, desmopressin showed higher efficacy and associated with less relapse rate.
Although several guidelines for Stress Ulcer Prophylaxis (SUP) have been published, Acid-Suppressive Therapy (AST) remains largely prescribed in hospitalized patients. Thus, our study aimed to ...evaluate the current practice surrounding SUP in Soba University Hospital (Khartoum, Sudan). This descriptive cross-sectional hospital-based retrospective study was conducted in the medicine unit of Soba University Hospital. The sample size was 317 participants, and data were collected from medical records from January to December 2018 using a validated checklist. SPSS was applied for data analysis. The mean age of patients was 53 ± 16.8 years, and 170 (54%) of them were female. The mean duration of hospital stay was 10 ± 7.4 days. Seventy-four percent of patients who received prophylaxis did not have an indication for SUP. The majority (116; 36.5%) of patients who were administered parenteral drugs can tolerate oral medications. Overall, the dose of acid-suppressant drugs was optimal in all patients. Proton Pump Inhibitors (PPIs), especially pantoprazole, are the dominant AST used (314; 99.1%). Moreover, 315 (99.4%) of the study population were taking medication during hospitalization and two (1%) patients were discharged with AST. The study concluded that SUP was administered to noncritically ill hospitalized patients who lacked or had few risk factors for gastrointestinal bleeding. PPIs were the overwhelming choice among practitioners. Collectively, the study showed low adherence to guidelines when prescribing (AST) outside critical care settings. Therefore, there is an urgent need for implementation of practical guidelines in noncritical care settings.
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder and cause of infertility in women of reproductive age. Knowledge of females about health problems is considered an ...important factor that promotes females’ health-seeking behavior. This study aimed to evaluate females’ knowledge and attitude toward PCOS as well as to assess PCOS prevalence among the participants.
Methods: A total of 240 females were included in the study between January and April 2019. A convenience sampling technique was used to select the participants. Data were collected using a self-administered questionnaire and analyzed using the Statistical Package for Social Sciences (SPSS) version 24. The analysis included frequencies of discrete variables and descriptors and cross-tabulation of the variables using the Chi-square test and logistic regression analysis. P < 0.05 was considered statistically significant.
Results: The results showed a low level of knowledge (scoring <9) in 41.3%, a good level (scoring between 9 and 15) in 21.3%, and also an excellent level of knowledge (scoring >15) in 37.5%. The Chi-square statistical test showed significant associations between the level of knowledge and education level, urban residence, health profession, marital status, and the prevalence of PCOS (p < 0.001, <0.001, <0.001, 0.045, and <0.001), respectively. Logistic regression showed that the females’ knowledge about PCOS was significantly associated with urban residence and being a health professional (p = 0.004 and p < 0.001, respectively).
Conclusion: The study highlighted that there was inadequate knowledge about the disease among participants and showed an urgent need to improve the knowledge about PCOS among Sudanese women.
Background: New onset diabetes after renal transplant (NODAT) is a serious complication of therapy with immunosuppressive drugs. The aim of this study was to estimate the incidence of NODAT and its ...association with immunosuppressant regimens within 6 months of the administration. Methodology: A descriptive retrospective case finding hospital-based study, conducted in the department of nephrology at Ahmed Gasim Hospital from January to September 2017, on patients who underwent renal transplantation between June 2015 and June 2016. The data were collected using a structured checklist. The collected data were analyzed by the Statistical Package for Social Sciences (SPSS). Results: A total of 110 patients were included, the majority of studied patients were males (71.8%) and in the age group of 20-40 years (50.9%). The most commonly prescribed immunosuppressant regimen was regimen, which consists of methylprednisolone as induction therapy and tacrolimus + azathioprine + prednisolone as maintenance therapy. Regarding the adverse effects, 11 (10%) of them developed NODAT throughout 6 months after transplantation. However, no significant association was found between the postulated risk factors and the incidence of NODAT. Conclusion: The incidence of NODAT was 10% throughout 6 months after transplantation. Correlations between sociodemographic characteristics, immunosuppressant regimens, episodes of rejection with the incidence of NODAT were found statistically insignificant.
Continuous therapeutic care with good medication adherence is the cornerstone of management of all chronic diseases including diabetes. This study aimed to evaluate the impact of clinical pharmacist ...intervention on the medication adherence in individuals with type 2 diabetes (T2DM).
This was a randomized, double-blind, controlled trial conducted at a diabetes clinic located at Omdurman Military Hospital, Sudan. Individuals with T2DM attending the diabetes clinic within 1 year were selected. The sample size was 364 participants (182 control and 182 interventional group). We used a pre-structured standardized questionnaire and checklist to collect the data. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) (version 28).
Majority, 76.4% (
= 278) were females, and they consisted of 80.8% (
= 147) of the interventional group and 72% of the controls. The mean age of the interventional group was 54.5 (±10) years; 31.9% (
= 58) of the interventional group had diabetes for 6-10 years, compared with 26.4% (
= 48) of the control group. Among the control group, the mean adherence score was 6.8 (±1.7) at baseline and it was 6.7 (±1.6) at the end of the study (
< 0.001), while in the interventional group, the mean adherence score was 6.8 (±1.7) at baseline and it was 7.4 (±1.5) at the end of the study (
< 0.001).
Adherence score among the intervention group was increased significantly from baseline to the end of the study when compared to the control group.
Mycetoma is classified as a neglected tropical disease, and despite its spread in Sudan, most physicians and pharmacists do not pay attention to the symptoms and proper treatment of mycetoma. Thus, ...this study aimed to evaluate knowledge and practice on mycetoma among community pharmacists in Khartoum state. A cross-sectional descriptive study was carried out among community pharmacists in Khartoum state, in the period from August to October 2021. Data was collected from the seven localities within Khartoum state using a validated self-administered questionnaire. The knowledge and practice of community pharmacists were assessed, and their association with demographic characteristics was calculated. Out of 347 pharmacists, 59.9% were females, 64.8% were between 22 and 28 years of age, and 79.3% were bachelor holders. Most of the participants (52.7%) had sufficient knowledge about mycetoma, the most common source of information was lectures (36.6%), more than half participants heard about the Mycetoma Research Center, and most of the cases seen by the participants were in the community (30.5%). There was no association between demographic data and knowledge score, except for knowing about the Mycetoma Research Center and attending workshops and seminars. Moreover, more than half of the participants showed good practice with mycetoma patients. The findings of the current study reflect that more efforts are needed to increase the knowledge and improve the practice of community pharmacists toward mycetoma.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background: Graft survival post-kidney transplantation is of paramount importance to patients and nephrologists. Nonadherence to immunosuppressive therapy can be associated with deterioration of ...renal function and graft rejection. This study aimed to evaluate the adherence to immunosuppressive medications in kidney transplant patients at three centers in Khartoum, Sudan.
Methods: In this descriptive cross-sectional hospital-based survey, 277 post-kidneytransplant patients were recruited. Data were collected using a questionnaire and analyzed using the SPSS v.23. Our scoring method was calculated based on Morisky Medication Adherence Scale (MMAS-8) related to immunosuppressive medications and was expressed as questions in the questionnaire; every correct answer was given one mark, then the marks were gathered and their summation was expressed.
Results: Overall, 33% ,45%, and 22% of the studied participants reported high, medium, and low adherence, respectively. The major factor for nonadherence was forgetfulness affecting 36.1% of those who did not adhere. The cost of the immunosuppressive medications did not negatively affect any of the participants’ adherence (100%). However, a significant association was seen between adherence and occupational status, duration of transplantation, shortage of immunosuppressants, recognizing the name of immunosuppressant, side effect, and forgetfulness (P-values = 0.002, 0.01, 0.006 , 0.000, 0.022, and 0.000, respectively). Logistic regression analysis showed a significant association with occupational status, side effects, and forgetfulness
Conclusion: Only one-third of the participants were classed as “highly adherent” to their immunosuppressant medications. Factors that can affect adherence to immunosuppressant medications were occupational status, side effects, and forgetfulness.
Background: Misoprostol and oxytocin are commonly prescribed drugs by obstetricians to induce labor and prevent postpartum hemorrhage. In Sudan, there is no national guideline for prescribing these ...drugs. Thus, the prescribers follow the international guidelines. Hence, our study aimed to evaluate the adherence of Sudanese obstetricians to the international guidelines for dispensing misoprostol and oxytocin.
Methods: A retrospective descriptive hospital-based study was performed at Saad Abu Ella hospital through their medical files archived in 2018 using a checklist designed by the researcher. Collected data were analyzed and presented in frequency tables using the statistical package for social sciences (SPSS).
Results: A total of 357 medical files were evaluated, about 50% of cases examined was in the 25–35 years age range, multigravida pregnant ladies were 62%. General indications of oxytocin and/or misoprostol were induction of labor (17%), postpartum hemorrhage prevention (PPH) after normal vaginal delivery (NVD) (30%) and cesarean sections (32%), evacuation of incomplete miscarriage (20%), and termination of pregnancy (1%). Compared to the guidelines, only 14% were given the recommended regimens for labor induction; 9.4% of women who had undergone NVD were given the recommended regimen to prevent PPH. While, 57% and 43% of the cases with incomplete miscarriage and termination of pregnancy were given the recommended regimens, respectively. Based on the correct indication, total adherence was estimated to be 17%.
Conclusions: Higher percentages of cases with incomplete miscarriage and intrauterine fetal death were given the recommended regimens to manage them. While, lower percentages of the participants were given the recommended regimens for labor induction and to prevent PPH.
Key words: misoprostol, oxytocin, obstetricians, adherence, international guidelines
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