Al Neelain Medical Journal - VOL -22
Permanent URI for this collectionhttps://repository.neelain.edu.sd/handle/123456789/12048
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Item Determination of CD4 T cells among children infected by HIV during anti-retroviral therapy (ART)(جامعة النيلين - مركز النيلين الطبي, 2018-06) Mohamed Elhassan Abakar, Saeed NasaddinAbstract Mother-to-child transmission is by far the commonest source of HIV infection in children. Therefore, its necessary to have a policy which provides the frame work, response intervention in the prevention, care and support of these infected and affected by the epidemic and mitigation of its impact. This study is conducted on newly born babies to mothers infected with HIV/AID to determine levels of CD4 T cells in an attempt to find a correlation between these level and the Mother-to-child transmission process, so it can participate in the ongoing efforts of control using anti retroviral therapy (ART). Level of CD4 cell in infected mothers was determined by using rapid test (determine), immunocomb and PCR (DBS). The effect of ART on vertical transmission of neonates was evaluated by using CD4 and PCR, DBS. HIV analysis in mothers infected using rapid test (Determine) (RT) and immunocomb gave similar results. HIV analysis in infected mothers and their infected infants using either RT or immunocomb test revealed similar results and CD4 count was high in the majority of the study population indicating the effectiveness of ART. Our findings suggest that CD4 count following ART initiation have appreciably changed in the majority of the study population. However in few children CD4 count had not influenced byItem Acute Scrotal Swellings In Children, Presentation & Management(جامعة النيلين - مركز النيلين الطبي, 2018-06) Aamir Abdullahi HamzaAbstract: Background: The term acute scrotum refers to acute scrotal pain. This presentation should always be treated as an emergency because of the possibility of testicular torsion and permanent ischemic damage to the testis. It presents a major diagnostic and therapeutic challenge. Objectives: The study aimed to assess the presentation and management of acute scrotum in paediatric surgery. Methods: It is a prospective descriptive analytical study, conducted on three hospitals in the period from Mar. 2013 - Nov. 2014. It included all paediatric patients of acute scrotum younger than 13 years. Data was reviewed and analyzed using SPSS version 20. Final diagnosis was made by Doppler ultrasound ± surgical exploration in all cases. Results: the findings included epididymoorchitis (39.5%), testicular torsion (34.2%), torsion of testicular appendage (10.5%), scrotal abscess (6.6%), haematocele (5.3%) and obstructed inguinal hernia (3.9%). The common triad of symptoms was pain (100%), swelling (90.8%) and fever (46.1%), while the common triad of signs was tenderness(96.1%), erythema (82.9%) and oedema (80.3%).Surgical exploration was performed in 49 patients (64.5%), findings were testicular torsion (n=26), torsion of testicular appendage (n=8), epididymoorchitis (n=7), scrotal abscess (n=5) and obstructed inguinal hernia (n=3). In testicular torsion group, salvage rate was 38.5% (n=10), in most of patients (90%) operated within 24 hours from symptoms onset, however, most patients underwent orchiectomy (n=15) were operated after 24 hours (P value 0.000). Conclusion: Although epididymoorchitis is the most common cause of acute scrotum in paediatric, testicular torsion is the most important differential diagnosis since delay in management leads to testicular loss. Unfortunately, testicular torsion cannot be consistently confirmed or rule out by history and clinical examination.Item The Role of Educational Intervention in Nurses’ Competence towards Paper-Based Medical Records Documentations at four main Hospitals in Khartoum State – Sudan 2014-2015(جامعة النيلين - مركز النيلين الطبي, 2018-06) Fadl Elmula Z. S., Bolad A. KAbstract: Background: Paper-based medical record is a backbone of all patients’ information during admission in the hospital. Growing use of medical records system in hospitals and other medical facilities throughout the world has been driven by the concrete fact that this system can help to improve the quality of health care as medical care gets more complex. Objectives: To study the role of educational intervention in nurses’ competence towards paper-based medical records documentations. Methods: This is a descriptive, interventional, analytical, hospital-based study recruited 150 nurses working at main hospitals in Khartoum State: Police Hospital in Khartoum North Province, Omdurman Teaching Hospital in Omdurman, Military Hospital in Omdurman Province and Khartoum North Teaching Hospital in Khartoum Province. The study assessed participants regarding their knowledge and performance towards paper-based medical records as well as some criteria training issues. They were subjected to pre-education assessment and post-education assessment and the study used pre-design questionnaire, then the data was analyzed by using statistical package for social sciences (SPSS, Vers. 21). Main findings: Out of 150 nurses assessed in the current study, females were 130(86.7%) versus 20 (13.3%) males, most of them were in the age of 22-30 years who were represented by 136 (90.7%) and have more than 5 years experience and they represented 118(78.7%) while 32(21.3%) had less than 5 years. Overall scores of nurses’ knowledge towards paper-based medical records in pre- and post-intervention assessment were (29.4% and 62.2%) respectively. remarkable improvement in level of knowledge after training was found regarding their believe Al Neelain Medical Journal (NMJ) Issue 22, June 2018 2 that, lack of time is the main reason that documentation does not get done (from 18% - 88%). Overall scores of nurses’ performance towards paper-based medical records in pre- and post-intervention assessment were (31.7% and 67.1%) respectively, they showed remarkable improvement regarding the ability to demonstrate knowledge of charting (8%-76.0%). Overall scores of nurses’ knowledge and attitude towards training issues in paper-based medical records in pre- and post-intervention assessment were (33.5%% and 62.2%) respectively. Discussion: Our findings showed a poor level of competence towards paper-based medical records as well revealed the effective role of educational intervention in increasing competence of nurses and the analysis revealed statistically significant difference regarding the pre- and post-intervention evaluation (P = 0.000). Conclusion: The study concluded that, there is poor knowledge and performance among nurses towards paper-based medical records as well as it revealed that educational intervention is effective in improving competence. مستخلص الدراسة: خلفية: إن التجوين عمى الدجلات الظبية يعتبخ العسهد الفقخي لسعمهمات السخيض أثشاء التشهيم بالسدتذفى. كسا أن الاهتسام الست ا ديج بأنغسة الدجلات الظبية في السدتذفيات والس ا خفق الرحية في العالم يعزج بحقيقة أن هحا الشغام قج يداعج عمى تقجيم مدتهى رعاية صحية أفزل في عل تذعب الخجمات الرحية. الأهداف: يهجف هحا البحث إلى تقييم دور التجخل التعميسي في أداء السسخضين والسسخضات تجاه التجوين عمى الدجلات الظبية. منهجية البحث: هحه د ا رسة وصفية تفاعمية تحميمية سخيخية تست بسذاركة 041 مسخض ومسخضة يعسمهن بأربعة مدتذفيات رئيدية بهلاية الخخطهم )مدتذفى الذخطة بالخخطهم، مدتذفى بحخي، مدتذفى أمجرمان التعميسي، مدتذفى الدلاج الظبي بأمجرمان ومدذتفى بحخي التعميسي ببحخي(. تم تقييم معخفة أداء السذاركين تجاه تجوين الدجلات الظبية كسا تشاولت الج ا رسة بعض عشاصخ التجريب. خزع السذاركين لتقييسين قبل وبعج التجريب باستخجام استبيان معج مدبقاً ثم تحميمها باستخجام بخنامج .) الحدمة الإحرائية لمج ا رسات الاجتساعية )الشدخة 10 75.6 %( بيشسا كان عجد الحكهر ( أهم النتائج: من بين 041 مسخض ومسخضة شاركها في الج ا رسة بمغ عجد الإناث 021 81.6 %( كسا كان أغمبهم لجيهم - ( %02.2 ( وكان معغم مجسهعة الج ا رسة في الفئة العسخية 21 11 سشة حيث مثمها 025 (11 10.2 %(مشهم خبخة أقل من 4 سشهات.أعهخت الج ا رسة أن ( 67.6 %( فيسا كان لجى 21 ( خبخة أكثخ من 4 سشة حيث بمغها 007 الستهسط الكمي لسعخفة السذاركين تجاه تجوين الدجلات الظبية قبل وبعج التجريب يبمغ ) 18.3 % و 51.1 % عمى التهالي(. Al Neelain Medical Journal (NMJ) Issue 22, June 2018 3 أعهخ التجريب تحدشاً ممحهعاً تجاه الاعتقاد بأن عامل الدمن هه الدبب الخئيدي لعجم كفاءة تجوين الدجلات الظبية )من % %07 إلى 77 %(. وكان متهسط الأداء الكمي لمسذاركين تجاه تجوين الدجلات الظبية قبل وبعج التجريب ) 20.6 و 56.0 %( عمى التهالي وأعهخت التجريب أيزاً تحدشاً ممحهعاً في قجرة السذاركين عمى استخجام السعمهمات التي تخص التجريب ) 7% إلى 65 %(. وجج أيزاً أن الستهسط الكمي لسعخفة ومهقف السخضين والسسخضات تجاه بعض عشاصخ التجريب قبل وبعج التجريب ) 22.4 % و 51.1 %( عمى التهالي. المناقشة: أثبتت نتائج الج ا رسة ضعف مدتهى أداء السسخضين والسسخضات تجاه تجوين الدجلات الظبية كسا أثبتت فعالية التجخل التعميسي في تحدين مدتهى الأداء حيث أعهخت الشتائج فخوقات ذات أهسية إحرائية فيسا يخص التقييم قبل وبعج .) التعميم )القيسة الاحتسالية . 1.14 الخلاصة: خمرت الج ا رسة إلى ضعف مدتهى معخفة وأداء السسخضين والسسخضات تجاه تجوين الدجلات الظبية كسا أثبتت فعالية التعميم في تحدين مدتهى الأداء.